| Delayed Epistaxis From Sphenopalatine Artery Following Transsphenoidal Surgery of Pituitary Adenoma |
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Sang-Yoon Lee , Seung-Jin Rho , Kil-Sung Chae , Hak-Gi Choi , Hwa-Seung Park , Chang-Gu Ghang |
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Department of Neurosurgery, Bongseng Memorial Hospital, Busan, Korea |
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| Abstract |
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To describe the role of angiography and embolization using Polyvinyl alcohol (PVA) contour particle in intractable massive epistaxis after transsphenoidal surgery of pituitary adenoma. One patient underwent microscopic transsphenoidal surgery through a right endonasal approach for nonfunctioning pituitary adenoma, Severe epistaxis suddenly developed On 13th day after operation. The epistaxis was due to arterial bleeding from posterior septal branch of sphenopalatine artery. Otolaryngologist failed to detect the origin of bleeding which was refractory to conservative treatment. Emergency internal carotid and exteranl carotid angiography performed during tight packing of the post. nasal cavity, showed extravasation of contrast media at dist. branch of right sphenopalatine artery. Patient was treated succesfully by endovascular embolization using Polyvinyl alcohol (PVA) contour particle without further complication. When delayed epistaxis follows transsphenoidal surgery and damage to the sphenopalatine artery has been ruled out, endovascular embolization of the external carotid artery should be considered in patients refractory to conservative treatment. |
| Key Words:
Endovascular embolizationㆍDelayed EpistaxisㆍSphenopalatine ArteryㆍTranssphenoidal SurgeryㆍPituitary adenoma |
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