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Bilateral Sphenopalatine Artery Embolisation in Panfacial fractures-a case report

Objective: To explore the possibility of performing bilateral superselective sphenopalatine artery ligation to control severe epistaxis encountered in multiple facial injuries, thus avoiding surgery and its associated morbidity.

Case description: This is the report of the first case done in our institution based on the principle of superselective embolisation of the sphenopalatine artery on both sides in order to control intractable nosebleed in the background of poor surgical and anaesthetic risk.

Result: Bilateral superselective sphenopalatine artery ligation effectively and safely controlled severe epistaxis in a single case of multiple facial fractures.

Conclusion: This is the first documented case of superselective embolisation of the sphenopalatine artery on both sides to manage a case of severe traumatic epistaxis. An extensive, expensive, difficult, and somewhat dubious surgical procedure was thus avoided. Replication of this procedure in indicated and selected cases in various centres involving more numbers of subjects could establish a new protocol for the management of intractable traumatic epistaxis.

Author(s): Jayita Poduval , Mark C Arokiaraj , Vinay Bhat , Nishant Savery

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