Eleven case series of transnasal endoscopic SAL (n=127) were included. One case series of each of seven other treatments were also included.
SAL.
The publication dates for case series ranged from 1996 to 2001.
The mean overall success rate for SAL was 98% (range: 92 to 100). The mean failure rate was 1.6% (range: 0 to 8). Only one study (38 patients) reported any complications. This study found nasal crusting in 34% of the patients, palatal numbness in 13%, acute sinusitis in 3%, decreased lacrimation in 3% and septal perforation in 3%.
The mean duration of surgery in the two studies reporting this outcome was 55 and 77 minutes. The mean duration of follow-up in the six studies reporting this outcome was 10 months (range: 9 to 13).
The success rate was 96% (81 patients) when using ligaclip alone, 100% (16 patients) when using diathermy alone, and 100% (29 patients) when using diathermy plus clip.
Comparisons with other treatments.
SAL had a higher success rate than the other treatments. The success rates for the other treatments were: 93% (145 patients) with transnasal microscopic ligation of sphenopalatine artery; 93% (15 patients) with ligation of external carotid artery; 91% (100 patients) with transantral ligation of internal maxillary artery; 90% (10 patients) with transnasal microscopic SAL; 88% (108 patients) with percutaneous embolisation of internal maxillary artery; 83% (6 patients) with endoscopic electric cautery; and either 48% (in the table) or 78% (in the text) with nasal packing (32 patients).