Effectiveness of Microwave Ablation for the Treatment of Epistaxis: A Systematic Review and Meta-Analysis

TL;DR

This paper reviews microwave ablation as a safe and effective treatment for nosebleeds, showing high success rates and low complications.

Contribution

The study provides a systematic review and meta-analysis of microwave ablation's efficacy for epistaxis, comparing it to traditional methods.

Findings

Microwave ablation showed a 97.3% success rate with minimal complications in 876 patients.

Meta-analysis found higher odds of recurrent bleeding with observation or silver nitrate versus microwave ablation.

Pain scores during microwave ablation were low and decreased rapidly afterward.

Abstract

Epistaxis is a common condition that is often benign and does not require serious intervention. The use of microwave ablation (MWA) is a relatively new technique for treating epistaxis. This systematic review examines the efficacy and safety of using MWA to treat common nosebleeds. It was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two databases, PubMed and EMBASE, were used to identify and aggregate articles for this systematic review. The search terms yielded a total of 2,691 articles with years ranging from 1947 to 2023. After screening, one case series, one randomized control trial, and five observational studies fit the inclusion criteria. Minimal complications were experienced by patients who underwent MWA treatment.

A total of 876 patients underwent MWA, with 852 reporting no recurrence at 3 or 6 months, indicating a 97.3% success rate. Three of the seven studies were pooled in a meta-analysis, revealing a pooled log odds ratio of 2.05 (95% CI: 1.19-2.91; p = 0.00), indicating higher odds of recurrent bleeding with observation or silver nitrate versus MWA. In a study of 83 patients, the average pain score was 1.83 during the MWA procedure and decreased to 0.95 one hour afterward. Overall, MWA is a safe and effective treatment for epistaxis, with low rebleeding and complication rates. Further research and a meta-analysis comparing MWA with traditional treatments are recommended to enhance our understanding.

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