Cauterization of the Anterior Ethmoidal Artery by Transconjunctival Approach

Study Overview
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Brief Summary
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The incidence of epistaxis varies from 7 to 14% in the general population and represents 30 per 100,000 emergency room admissions in adults. Most nasal bleeding is self-limiting without the need for specific medical treatment. Cauterization under local anesthesia and control of medical comorbidities (arterial hypertension and hemostasis disorders) are effective in most cases. In case of failure of cauterization or in case of more posterior epistaxis, an antero-posterior packing can be put in place for 48 hours. In case of failure or recurrence of packing removal, endoscopic sphenopalatine artery (SPA) ligation or embolization is proposed. In case of persistent epistaxis despite hemostasis of the PSA, ligation of the anterior ethmoidal artery (AEA) is recommended. This artery cannot be embolized because of the risk to the ophthalmic artery. The ligation of the AEA is most often performed via the external paracanthal approach. It can also be performed by endonasal endoscopic approach but involves the performance of an anterior ethmoidectomy, a long surgery with a significant risk of complications. Its identification by the endonasal route is complicated in the event of abundant bleeding. Moreover, its endoscopic cauterization is difficult if the artery is not procidente. The transconjunctival approach avoids a visible scar and the complications of an ethmoidectomy.

Detailed Description
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The objective of the study was to compare the efficacy of transconjunctival and external cauterization of the anterior ethmoidal artery in patients with refractory epistaxis

Official Title
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Cauterization of the Anterior Ethmoidal Artery by Transconjunctival Approach

Conditions
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Epistaxis, Anterior Ethmoid Artery

Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Male or female (age ≥18 years) Persistent epistaxis after meching Having required transconjunctival anterior ethmoidal artery cauterization surgery Subject operated at the University Hospitals of Strasbourg between 01/01/2015 and 01/05/2023 Subject not objecting to the reuse of his/her data for scientific research purposes. Exclusion Criteria: - Subject who has expressed opposition to the reuse of his/her data for scientific research purposes.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To retrospectively compare the efficacy of transconjunctival and external cauterization of the anterior ethmoidal artery in patients with refractory epistaxis | The endpoint is the efficacy of the technique with the presence of postoperative epistaxis recurrence | Files analysed retrospectively from January 01, 2015 to May 01, 2023 will be examined | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Arterial hypertension, Hemostasis disorders, Endoscopic sphenopalatine artery, Endonasal endoscopic, Anterior ethmoidectomy, Epistaxis, Anterior Ethmoid Artery