Therapeutic embolization for severe epistaxis.

Severe intractable epistaxis remains a therapeutic challenge for the otolaryngologist. Embolization would appear to add a valuable treatment modality in dealing with particular cases refractory to conventional management. In selective cases it may prove superior to surgical intervention because of repeated accessibility and circumvention of the problem of collateral internal maxillary artery flow. This paper presents three cases of epistaxis of unusual causes which were initially uncontrolled by conventional management. Each patient received preliminary selective carotid angiography followed by one of two different intra-arterial embolization methods. The results were effective and illustrate the potential adjunctive or primary role embolizing procedures have in dealing with uncontrolled epistaxis.