Author(s)
Chester F Griffiths1
Daniel F Kelly, MD1
Garni Barkhoudarian, MD2
Walavan Sivakumar, MD2
Frank Berry, MD2
Affiliation(s)
1Saint John's Cancer Institute; 2Pacific Neuroscience Institute
Abstract:
Postoperative life threatening/posterior sinonasal epistaxis in endonasal skull base surgery published incidence is between 0-7% with the unfortunate risk of mortality. Our institution uniformly adopted a bilateral sphenopalatine-posterior nasal artery preservation technique in 2011, publishing our retrospective analysis of 174 from August 2011 to July 2013. Since August 2013 until June 2022 our center has performed 716 endonasal procedures representing various skull base pathologic conditions for a total of 890 procedures. In that time period, 2 major incidences of postoperative epistaxis occured related to improper technique of a junior faculty member with an incidence of 0.2%. The senior author has experienced no episodes of major epistaxis while preserving and not ligating the sphenopalatine-posterior nasal artery vascular structures. Of note is our prior publication of anosmia avoidence with this technique. Due to the serious sequale of postoperative posterior sinonasal epistaxis, we recommend adoption of this technique for complication avoidance.