난치성 후방 비출혈 환자에서 내시경하 접형구개동맥 소작술과 선택적 동맥 색전술의 비교 분석

Background and Objectives: The purpose of this study was to compare treatment modality of ESPAL and arterial embolization in patients with intractable posterior epistaxis. Subjects and Methods: This study was a retrospective review of 16 patients with intractable posterior epistaxis. Twelve patients were treated with ESPAL and four patients with arterial embolization. Success rates, duration of procedure, hospital stay, hospital cost, postoperative complications were analyzed. Results: Rebleeding occurred in two patients treated with ESPAL. One patient was successfully controlled with reoperation. The other surgical failure was controlled with embolization due to SPA pseudoaneurysm. The success rate of ESPAL and embolization was 83.3% and 100%, respectively. Two of four patients received embolization had pseudoaneurysm in the descending palatine artery. The mean duration of procedure and hospital stay was 82.5 minutes and 8.1 days in ESPAL, but 96.7 minutes and 6.0 days in embolization, respectively. The mean total cost of ESPAL was 3,380,000 won, 4,090,000 won for embolization. There were no major complications in both groups. Conclusions: Both ESAPL and arterial embolization had similar high success rates in controlling intractable posterior epistaxis. However, arterial embolization may be a better initial option in patients suspected of pseudoaneurysm and in surgical failures. (J Clinical Otolaryngol 2017;28-:62-66)