respiratory nasal mucosa after endoscopic sphenopalatine artery coagulation. A histological and histochemical study

ABSTRACT

Epistaxis is regarded as the commonest emergency requiring admission to the otolaryngology departments. Endoscopic coagulation of sphenopalatine artery is indicated in patients with posterior epistaxis unresponsive to nasal packing. Although many studies dealt with the efficacy of the procedure in controlling severe Epistaxis, few studied its effect on the nasal structure and functions. The aim of the present work was to study the effect of sphenopalatine artery coagulation on the secretory activities as well as the histological and histochemical changes of the nasal mucosa. The study was performed on 20 adult patients suffering from persistent or recurrent posterior epistaxis. Punch biopsies from the inferior turbinate were stained with hematoxylin and eosin and PAS alcian blue for histological examination while histochemical examination was done for the activity of succinic dehydrogenase, alkaline phosphatase and cholinesterase enzymes. Histologically; the nasal mucosa showed marked decrease in the size of both the seromucinous acini and blood sinusoids in the subendothelial connective tissue stroma in the post operative biopsies. Hitochemically; all enzymatic activities showed noticeable decrease in the postoperative biopsies. No degenerative changes were noticed in any postoperative biopsy. Sphenopalatine artery coagulation is an effective method in controlling recurrent or persistent posterior nasal bleeding that affects to some extent the secretory functions of the nasal mucosa on short term with no long term harmful effects