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Evaluating nasal cautery techniques in epistaxis

  • J Bastianpillai (a1), C Saxby (a1), P Coyle (a2), A Armstrong (a3), W Mohamid (a4) and G Mochloulis (a5)...

Abstract

Background

Silver nitrate cautery and bipolar electrocautery are commonly used in the treatment of epistaxis. Currently, there are no recommendations on optimum contact times or power for nasal cautery. ENT consultant practice in the UK has not previously been evaluated.

Methods

This study examined the burn depth associated with silver nitrate (75 per cent concentration) cautery and bipolar electrocautery on porcine septum samples, using varying contact times and power. ENT consultants completed a survey evaluating their practice.

Results and conclusion

ENT consultant practice of nasal cautery was shown to vary widely. Silver nitrate cautery with a contact time of less than 30 seconds does not cause a full thickness burn. The findings lend some support to bilateral cauterisation with silver nitrate. Bipolar electrocautery should be set at lower than 10 W and with a contact time of less than 4 seconds to reduce the risk of complications associated with a full thickness burn.

Copyright

Corresponding author

Author for correspondence: Mr Johan Bastianpillai, Department of Ear, Nose and Throat Surgery, Northwick Park Hospital, London HA1 3UJ, UK E-mail: johan.bastianpillai@nhs.net

Footnotes

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Mr J Bastianpillai takes responsibility for the integrity of the content of the paper

Presented at the Royal Society of Medicine Laryngology and Rhinology Section Meeting, 3 February 2017, London, UK.

Footnotes

References

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9Hanif, J, Tasca, R, Frosh, A, Ghufoor, K, Stirling, R. Silver nitrate: histological effects of cautery on epithelial surfaces with varying contact times. Clin Otolaryngol Allied Sci 2003;28:368–70
10Glynn, F, Amin, M, Sheahan, P, McShane, D. Prospective double blind randomized clinical trial comparing 75% versus 95% silver nitrate cauterization in the management of idiopathic childhood epistaxis. Int J Pediatr Otorhinolaryngol 2011;75:81–4
11Johnson, N, Faria, J, Behar, P. A comparison of bipolar electrocautery and chemical cautery for control of pediatric recurrent anterior epistaxis. Otolaryngol Head Neck Surg 2015;153:851–6
12Felek, SA, Celik, H, Islam, A, Demirci, M. Bilateral simultaneous nasal septal cauterization in children with recurrent epistaxis. Int J Pediatr Otorhinolaryngol 2009;73:1390–3

Keywords

Evaluating nasal cautery techniques in epistaxis

  • J Bastianpillai (a1), C Saxby (a1), P Coyle (a2), A Armstrong (a3), W Mohamid (a4) and G Mochloulis (a5)...

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