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Management of intractable epistaxis: endoscopy or nasal packing?

Published online by Cambridge University Press:  01 March 2012

Y Liu ,
C Zheng ,
W Wei  and
Q Liu
Y Liu
Affiliation:
Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
C Zheng*
Affiliation:
Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
W Wei
Affiliation:
Department of Otolaryngology, Huadong Hospital, Fudan University, Shanghai, China
Q Liu
Affiliation:
Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
*
Address for correspondence: Dr Chunquan Zheng, Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, 83 Fen Yang Road, Shanghai 200031, China Fax: +86 21 64377151, E-mail: zhengdoctor96@yahoo.com.cn
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Abstract

Objectives:

To investigate common origins of intractable epistaxis, and the efficacy of endoscopic management.

Methods:

Retrospective study of 265 patients with uncontrolled idiopathic epistaxis presenting between July 2008 and July 2009. Patients underwent endoscopic examination and subsequent radiofrequency electrocautery, selective packing or observation.

Results:

Nasal endoscopy indicated that the commonest bleeding sources were the superior nasal septum at the olfactory cleft (39.2 per cent), the inferior meatus (27.5 per cent), the sphenoethmoid recess (6.0 per cent), the middle meatus (5.3 per cent) and other locations (3.4 per cent). Bleeding was successfully controlled with nasal endoscopy plus radiofrequency electrocautery or selective packing. In 49 (18.5 per cent) patients, no abnormality was identified; these patients received observation only, and no further bleeding occurred. None of the patients had serious complications or recurrent epistaxis during the three-month follow-up period.

Conclusion:

Thorough endoscopic examination combined with radiofrequency electrocautery should be used as first-line therapy for intractable epistaxis.

Keywords

EpistaxisEndoscopic Surgical ProceduresAnatomyPathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 5 , May 2012 , pp. 482 - 486
Copyright
Copyright © JLO (1984) Limited 2012

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