Endoscopic endonasal ligation of the sphenopalatine artery

Internal maxillary artery ligation for persistent posterior epistaxis is tr aditionally performed via the transantral approach. Although usually effect ive in controlling the bleeding it carries significant risks, including dam age to the infraorbital nerve, damage to dentition and oro-antral fistula f ormation. The alternative procedure of endoscopic ligation of the sphenopalatine arte ry at its exit from the sphenopalatine foremen avoids the morbidity associa ted with the transantral approach. The technique we describe involves the u se of standard FESS instruments and a Ligge Clip applicator. This operation is well within the capability of the Otolaryngologist / Rhinologist experi enced in endoscopic sinus surgery.