Clinical Features And Treatment Of Postoperative Delayed Epistaxis After Endoscopic Endonasal Transsphenoidal Surgery

Objectives: To investigate the clinical features and treatment of postoperative delayed epistaxis after neuroendoscopy endonasal transsphenoidal surgery.Methods: The clinical data of 21 patients with delayed epistaxis after neuroendoscopy endonasal transsphenoidal surgery were retrospectively analyzed,and the clinical features and prognosis of the complication were analyzed.15 cases underwent cerebral angiography(12cases underwent cerebral angiography and selective internal maxillary artery embolization,2case underwent nasal endoscopic packing hemostasis,1case of internal carotid arterial pseudoaneurysm hemorrhage was treated by fluency plus),5 cases underwent endoscopic transnasal sphenoidal exploration hemostasis,1 case respiratory arrest caused by apnea due to massive epistaxis.Results: The incidence of postoperative delayed nasal bleeding was 1.5%;postoperative bleeding in less than or equal to 2 days after surgery was 2 case,postoperative delayed epistaxis in 3 to 15 days after surgery were15 cases,postoperative bleeding in 3 to 4 weeks after surgery were 4 cases,and the mean bleeding time was 8.08 days after surgery;there were 3 cases of small amount of nasal bleeding,12 cases of persistent slow nasal bleeding,5 cases of refractory nasal bleeding and 1 case of sudden nasal bleeding.1 cases died of respiratory arrest,while 20 cases stopped bleeding after individualized treatment and no recurrence occurred postoperative follow-up.Conclusions: Delayed epistaxis is a rare complication of endoscopic endonasal transsphenoidal surgery,and it is very dangerous.Accurate diagnosis,rapid and individualized treatments are very important for the control of bleeding.