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Identification of common bleeding points in intractable epistaxis

Published online by Cambridge University Press:  09 September 2025

Holly Jones ,
Alison McHugh Open the ORCID record for Alison McHugh [Opens in a new window] ,
John Lang  and
Bronagh Lang
Holly Jones
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Ireland
Alison McHugh*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Ireland
John Lang
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Ireland
Bronagh Lang
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Ireland
*
Corresponding author: Alison McHugh; Email: alisonmchugh@rcsi.com
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Abstract

Objectives

To localise bleeding points identified in patients with intractable epistaxis.

Methods

We reviewed all patients with intractable epistaxis who underwent endoscopic nasal examination under anaesthesia between 1989 and 2024 in a tertiary otolaryngology unit in Ireland.

Results

In total, 194 patients were included. Bleeding points were identified in 85 per cent of patients (165 cases). In addition, 89 patients (46 per cent) had bleeding from the septum, 70 (36 per cent) of which were high on the anterosuperior septum above the axilla of the middle turbinate. It was also found that 77 patients (40 per cent) had bleeding from the lateral nasal wall: 44 (23 per cent) at the posterior end of the middle meatus and 33 (17 per cent) at the posterior end of the inferior meatus.

Conclusion

This study describes remarkably consistent bleeding point localisation in epistaxis failing first-line measures. We recommend detailed endoscopic examination as a first-line intervention in such instances. Direct cauterisation is the simplest method for controlling epistaxis, avoiding complex procedures such as arterial ligation or embolisation.

Keywords

epistaxisnosenasal septumturbinateshemorrhageendoscopes

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 4
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Alison McHugh takes responsibility for the integrity of the content of the paper

References

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