Review Article

Control of Bleeding in Endoscopic Skull Base Surgery: Current Concepts to Improve Hemostasis

Table 4

Controlled bleeding techniques in endoscopic endonasal surgery.

SituationSourceTechnique

Artery
 Low-flow bleeding Small perforating vessels
Small arteriole
Bipolar electrocautery
Hemostatic biomaterial agents
 High-flow bleeding Medium to large artery Bipolar electrocautery
Clips
Angiography embolization

Venous
 Low-flow bleedingBleeding from mucosa, boneWarm saline irrigation
Drilling with diamond bur or applied bone wax with pledget (if presented focal bleeding from bone)
Focal bleeding from venous sinus Hemostatic biomaterial agents
 High-flow bleedingVenous sinus bleeding Hemostatic biomaterial agents