LAUSR

Though most authors agree that TESPAL (transnasal endoscopic sphenopalatine artery ligation) should be considered in case of epistaxis resistant to nasal packing, there is no consensus on the indication for a unilateral/bilateral procedure. In this retrospective study of 83 patients with spontaneous intractable unilateral spontaneous epistaxis, we compared the outcomes of unilateral (n=36) vs bilateral (n=47) TESPAL. The main outcome was failure, defined as bleeding recurrence requiring another therapeutic procedure under general anaesthesia. The success rate was higher with bilateral TESPAL (91.5%) than with unilateral TESPAL (75%), without any major complication (p=0.041). This retrospective study supports the rationale for bilateral rather than unilateral TESPAL, and paves the way for further prospective studies. This article is protected by copyright. All rights reserved.