RESUMEN
Epistaxis from the posterior superior region of the nasal cavity might be fatal in some cases. It is particularly severe in an individual with hypertension, arterial aneurysm of traumatic origin, and bleeding from posterior lateral nasal artery, which is frequently difficult to reach and ligate directly on a bleeding area. Certain cases have been reported in which the bleeding could be stopped only by ligating/embolization of the external carotid artery or the internal maxillary artery at its branching off from the external carotid artery. Despite the multiple anastomoses, the effect of such ligation or cauterization is effective if properly done. We present a case of a 25-year-old young man with a 3-month history of recurrent epistaxis resulting from an internal maxillary artery aneurysm following trauma. The clinical presentation, diagnosis, and successful endoscopy treatment of posterior epistaxis are presented.
RESUMEN
By 2030, 70% of cancers will occur in developing countries. Head and neck cancers are primarily a developing world disease. While anatomical location and the extent of cancers are central to defining prognosis and staging, the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) have incorporated nonanatomic factors that correlate with prognosis into staging (eg, p16 status of oropharyngeal cancers). However, 16 of 17 head and neck surgeons from 13 African countries cannot routinely test for p16 status and hence can no longer apply AJCC/UICC staging to oropharyngeal cancer. While the AJCC/UICC should continue to refine staging that best reflects treatment outcomes and prognosis by incorporating new nonanatomical factors, they should also retain and refine anatomically based staging to serve the needs of clinicians and their patients in resource-constrained settings. Not to do so would diminish their global relevance and in so doing also disadvantage most of the world's cancer patients.