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Does epistaxis with an unknown bleeding site originate from the posterior part of the nasal cavity?

  • Z-C Lou (a1)

Abstract

Objective

To review the origins of epistaxis in patients with unknown bleeding sites.

Methods

This consecutive case series included 26 patients with unknown bleeding sites previously considered to have posterior epistaxis. All patients had previously been examined endoscopically at least once, and were again examined with 30°, 45° and 70° endoscopes.

Results

The bleeding site was at the: anterior end of the lateral wall of the inferior meatus in one patient (3.8 per cent); anterosuperior lateral wall of the nasal cavity in five patients (19.2 per cent); anterior nasal cavity roof in seven patients (26.9 per cent); anterosuperior part of the cartilaginous septum in nine patients (34.6 per cent); ostium pharyngeum tubae in two patients (7.7 per cent); and anterior nasal base in two patients (7.7 per cent). The morphology of the bleeding point showed: nasal mucosa ulceration in 1 patient, isolated primary telangiectasia in 3 patients, prominent vessels in 5 patients and capillary angioma in 17 patients.

Conclusion

Epistaxis originating from the anterosuperior nasal cavity and nasopharynx can be easily misdiagnosed as posterior epistaxis or unknown bleeding sites. Areas that should be considered as possible origins of epistaxis in cases with unknown bleeding sites were identified.

Copyright

Corresponding author

Author for correspondence: Dr Zheng-Cai Lou, Department of Otorhinolaryngology, Yiwu central Hospital, 699 Jiangdong Road, Yiwu City 322000, China E-mail: louzhengcai@163.com

Footnotes

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Dr Z-C Lou takes responsibility for the integrity of the content of the paper

Footnotes

References

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