Trans-nasal endoscopic sphenopalatine artery ligation (TESPAL)

What is it?

Trans-nasal endoscopic sphenopalatine artery ligation is an endoscopic procedure done for intractable  nasal bleed/epistaxis which occurs even after all the systemic causes have been assessed and addressed.

What is the aim of the procedure?

The aim of the procedure is to ligate the Sphenopalatine artery which is the major artery supplying the nasal cavity so as to stop the ongoing nasal bleed.

What is done during the procedure?

The procedure involves use of an endoscope which is introduced into nasal cavity on the side with the bleed to visualize and clip the artery.

The procedure will be carried out under general anesthesia. If you have any anesthetic concerns, please discuss with your anesthetist.

What are the risks associated with the procedure?

• Infection of the operated site.

• Dryness of nose

• Impaired sense of smell

• Damage to the eyeball leading to visual disturbances

• Damage to the tear duct

  
  
  
  

Post-operative care and follow-up:

You will be discharged on the day following the surgery, if no complications are encountered. You may have to be on follow-up with your doctor for a period of 1 month. During each visit nasal endoscopy may be performed to assess operated site. Based on the condition, you will be prescribed medications during each visit.

a. How long should I stay in the hospital post procedure

1-2 days based on your general condition

b. How much time should I take off work?

It's best to take it easy for 2-3 days.

c. Can my nasal bleed occur again

Yes, there is a small possibility. but since we are clipping the major blood vessel on the side of nasal bleed. It is highly unlikely to get it again

d. What can I eat after the procedure?

No special diet is needed, but it's best to avoid cold stuff like iced drinks and ice cream to prevent catching a cold, which might slow down healing.

e. Can I travel by bike/taxi or go on long trips after the procedure?

It's best to hold off for a week. After that, follow your doctor's advice.