Document Detail


Treatment of profuse epistaxis in patients irradiated for nasopharyngeal carcinoma.
MedLine Citation:
PMID:  17388834     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Profuse epistaxis in patients with nasopharyngeal carcinoma (NPC) previously treated with radiotherapy (RT) can be life threatening. Surgical means to prevent rebleeding may at times be difficult and unsuccessful. We aim to investigate the characteristics of this group of patients and our experience of endovascular embolization technique in the management of epistaxis in this group of patients. METHODS: A retrospective review of all nasopharyngeal carcinoma patients presented with profuse epistaxis during follow up after radiotherapy was carried out in a regional neurosurgical centre in Hong Kong. Seventeen patients were included for the analysis within the recent 6-year period. The age of patients was 55.5 +/- 8.358 years (mean +/- standard deviation). The sex ratio was 5:1 (M : F). Diagnostic catheter angiography was carried out in all 17 patients. Endovascular embolization was carried out in 11 patients with the joint decision of the otolaryngologist and neurointerventionist in charge . RESULTS: Four patients underwent main trunk occlusion for internal carotid pseudoaneurysm. Seven patients underwent embolization of branches of external carotid artery. One patient required another session of external carotid artery embolization 1 month later. There was one inpatient death because of pneumonia and hepatic encephalopathy. With our protocol, there were only two patients (11.7%) with delayed rebleed at 2 and 5 months, respectively. Both patients had advanced diseases and died. CONCLUSION: In irradiated patients with nasopharyngeal carcinoma presenting with profuse epistaxis, angiography had a high yield of pseudoaneurysm or hypervascularity and these lesions could be safely managed through endovascular embolization.
Authors:
George K C Wong; Kin K Chan; Simon C H Yu; Raymond K Y Tsang; Wai S Poon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ANZ journal of surgery     Volume:  77     ISSN:  1445-1433     ISO Abbreviation:  ANZ J Surg     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-28     Completed Date:  2007-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  270-4     Citation Subset:  IM    
Affiliation:
Division of Neurosurgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography
Embolization, Therapeutic / methods*
Epistaxis / etiology*,  mortality,  therapy*
Female
Humans
Male
Middle Aged
Nasopharyngeal Neoplasms / radiotherapy*
Radiotherapy / adverse effects*
Recurrence
Retrospective Studies
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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