Percutaneous embolization to control intractable epistaxis in nasopharyngeal carcinoma

Background. Epistaxis in patients with nasopharyngeal carcinoma (NPC) who h ave received radiotherapy can be difficult to control by conventional metho ds. The use of angiography and embolization to control problematic epistaxi s has been well documented in other situations, but its use in severe or re current epistaxis following irradiation for NPC has not been described. Methods. We retrospectively reviewed case notes of all patients with NPC in itially seen with epistaxis over a 4-year period. Those patients with refra ctory epistaxis which could not be controlled by conventional methods and r equired angiography and embolization were assessed. Results. Eight patients who underwent angiography were identified. Five pat ients showed hypervascularization and three patients had pseudoaneurysms or an aneurysm of the internal carotid artery seen on the angiogram. All thes e patients were successfully embolized. There were no significant complicat ions after the procedure. Conclusion. We conclude that embolization is a safe and effective method of controlling refractory epistaxis in patients irradiated for NPC. (C) 1999 John Wiley & Sons, Inc.