Endoscopic Sphenopalatine Artery Ligation — Active Bleeding
Indications:
- Control of epistaxis
- Vascular control prior to tumor removal
Highlights:
- Incision is made over the palatine bone just posterior to maxillary fontanelle.
- Crista ethmoidalis serves as a landmark just anterior to sphenopalatine foramen.
- Endoscopic clip appliers facilitate clip application.
Keep in Mind/Things to Remember:
- SPA may branch prior to exiting foramen, often with larger SPA branch and smaller posterior nasal branch.
- Isolation of artery from surrounding fascia facilitates clip application and/or cauterization.