Clinical Research Of Delayed Traumatogenic Epistaxis

Objective: To explore the diagnosis and treatment of delayed traumatogenic epistaxis and advance the concept of maxillofacial medium-sized artery and arteriola pseudoaneurysmal epistaxis.Methods: Analyzing retrospectively the clinical materials of 53 cases who had the typical symptoms of delayed traumatogenic epistaxis and received digital subtraction angiography (DSA) examination and treatment from March 1990 to March 2004.Results: In this study, 8 cases suffered from pseudoaneurysm in interal carotid artery (ICA) ,of these cases, 1 case died of massive epistaxis before embolization,7 received transcatheter arterial embolization,6 cured and 1 died.20 cases from traumatic carotid cavernous fistula were cured with endovascular occlusion by detachable balloon,of these cases, 15 by simple embolization,3 by fistula and ICA embolization,and 2 by ICA embolization.Of the 25 from maxillofacial artery hemorrhage,21 treated by transcatheter arterial embolization with gelatin sponge and coils,4 by anterior ethmoidal artery ligation.Only one patient who received transcatheter arterial embolization recurred hemorrhage after three weeks and was recured by artery ligation,the others were cured without serious complications and recurrent hemorrhage.Conclusion: Interal carotid artery pseudoaneurysm ,carotid cavernous fistula and maxillofacial medium-sized artery and arteriola pseudoaneurysm are the main causes of delayed traumatogenic epistaxis. Early diagnosis by DSA and transcatheter arterial embolization or artery ligation are the useful methods to these diseases.