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J.J. Vavrina - T. Hummel - B.N. Landis - S. Macario - M.B. Soyka

DOI: 10.4193/Rhin24.314

BACKGROUND: The sphenopalatine artery (SPA) runs in close proximity to the branches of the trigeminal nerve and to the sympathetic and parasympathetic secretomotor fi bers. In refractory epistaxis, monopolar cautery of the SPA during surgery is of widespread
use. The eff ect of coagulation on adjacent trigeminal and parasympathetic branches, and thus intranasal sensitivity and secretory function, is unknown. METHODS: To investigate intranasal trigeminal function (INTF) by means of CO2 stimuli intranasally, at baseline and after decongestion, before and after local anaesthesia (xylocaine) in healthy subjects and after monopolar cautery in patients treated for refractory epistaxis. In the latter, INTF and secretory function were tested by comparing the treated with the untreated side. Nasal and lacrimal secretions were measured with intranasal sponges and Schirmer’s tests. SETTING: Monocentric cohort study in tertiary referral centre. RESULTS: A total of 37 healthy participants and 17 patients were included. Nasal decongestion had no eff ect on CO2 measurements, whereas local anaesthesia signifi cantly decreased INTF in healthy subjects. In patients, the operated side showed signifi cantly lower INTF, lower nasal secretory function but no signifi cant changes in lacrimal function.CONCLUSION: Local anaesthesia and surgical treatments have measurable eff ects on INTF. Monopolar cautery of the SPA and its branches aff ects nasal secretory function. These eff ects may lead to symptoms and surgeons should be aware of the potential harm in epistaxis treatments.

Rhinology 0-0: 0-0, 0000