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In This Issue of JAMA Otolaryngology
September 2014


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JAMA Otolaryngol Head Neck Surg. 2014;140(9):791. doi:10.1001/jamaoto.2013.4310

As interventional radiology has become more sophisticated, so too have the choices for treatment of severe posterior epistaxis. Treatment with a posterior nasal pack and multiple days of hospitalization are a thing of the past. But not infrequently, patients are referred to tertiary centers with a specific request from the referring physician for treatment via arterial embolization of the sphenopalatine artery. In this era of cost-effective health care, Rudmik and Leung chose to perform a cost analysis for the treatment of severe posterior epistaxis by using both techniques. The outcome was the control of the bleeding, and the evaluation was to determine incremental cost. Embolization was effective but was about $8000 more than endoscopic ligation; both were equally effective. While patient and institutional factors need to be considered when choosing treatment options, the significantly lower cost of endoscopic ligation should be added to the decision-making tree.

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