International Journal of Otolaryngology and Head & Neck Surgery, 2020, 9, 78-85 https://www.scirp.org/journal/ijohns ISSN Online: 2168-5460 ISSN Print: 2168-5452 DOI: 10.4236/ijohns.2020.92011 Mar. 9, 2020 78 Int. J. Otolaryngology and Head & Neck Surgery Analysis of Endoscopic Sphenopalatine Artery Surgery for Refractory Epistaxis Takahiro Kitamura * , Yukinori Takenaka, Kengo Aoki, Takuma Shimada, Hiroko Hamaguchi, Ayaka Nakatani, Masayuki Nozawa, Ryohei Oya, Yoshifumi Yamamoto, Atsuhiko Uno Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan Abstract Background: This study aimed to determine the safety and efficacy of sphe- nopalatine artery (SPA) surgery in patients with refractory epistaxis and to identify factors associated with the indications for surgery to assist clinicians in making prompt and appropriate decisions regarding SPA surgery for re- fractory epistaxis. Methods: We analyzed 97 consecutive patients with nasal bleeding hospitalized in our institution between April 2009 and March 2018. Clinicopathological characteristics and clinical outcomes were analyzed from retrospective chart reviews. Results: Of the 97 patients, 28 (29 sides) required SPA surgery. There were no differences in sex, anti-coagulant drug or anti- platelet use, hemoglobin concentration, or platelet count between Group A (patients who required surgery) and Group B (patients who did not require surgery). Age (58 vs. 67 years, p = 0.038) and severity of comorbidity (0 vs. 1, p = 0.039) were significantly lower in the surgery group. Patients who were younger and had lower Charlson Comorbidity Index (CCI) scores had more requirements for surgery than those who were older and had higher CCI scores. There was no significant difference between the groups with respect to the proportion of patients receiving blood transfusions; however, the length of hospitalization was significantly longer in Group A than in Group B (8.9 vs. 8 days, p = 0.038). Success rate (non-rebleeding rate) was 89%, compara- ble to that reported in previous studies. Conclusions: Endoscopic SPA sur- gery was found safe and effective method with few complications. Younger patients with lower CCI scores were found appropriate for SPA surgery for refractory epistaxis due in part to a lower risk of anesthesia. Keywords Epistaxis, Sphenopalatine Artery, Emergency, Admission, Cauterization, Ligation, Endoscope How to cite this paper: Kitamura, T., Takenaka, Y., Aoki, K., Shimada, T., Ha- maguchi, H., Nakatani, A., Nozawa, M., Oya, R., Yamamoto, Y. and Uno, A. (2020) Analysis of Endoscopic Sphenopalatine Artery Surgery for Refractory Epistaxis. International Journal of Otolaryngology and Head & Neck Surgery, 9, 78-85. https://doi.org/10.4236/ijohns.2020.92011 Received: February 5, 2020 Accepted: March 6, 2020 Published: March 9, 2020 Copyright © 2020 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access