Microwave ablation for the treatment of arterial epistaxis: “how I do it”

Background

Arterial epistaxis is commonly seen in the rhinology clinic and can have a significant impact on quality of life. Previous studies have explored various therapies to address epistaxis.

Methods

Patients were treated in the outpatient clinic or operating room by microwave ablation (MWA) with a 2450‐MHz cooled‐shaft antenna to treat an epistaxis bleeding point.

Results

Of the 481 patients with arterial epistaxis, bleeding was controlled within 1 to 2 minutes and only 2 patients with recurrent bleeding required re‐ablation. The shape of the thermal lesion was elliptical and it was approximately 2 mm in length, 1 mm in width, and 0.5 to 1 mm in penetration depth. Of the 481 patients, 167 (34.7%) complained of minor nasal pain on the same day of ablation. No patients complained of nasal pain or obstruction during the follow‐up period. In addition, 139 (28.9%) patients showed a minor increase in rhinorrhea during the first postoperative week. Of the 481 patients, 469 (97.5%) were followed‐up at 6 months with no severe MWA‐related complications, such as septal perforation, synechiae formation, or orbit and brain complications.

Conclusion

MWA is a technically feasible alternative method for patients with arterial epistaxis.

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