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Evaluating nasal cautery techniques in epistaxis

Published online by Cambridge University Press:  07 October 2019

J Bastianpillai ,
C Saxby ,
P Coyle ,
A Armstrong ,
W Mohamid  and
G Mochloulis
J Bastianpillai*
Affiliation:
Department of Ear, Nose and Throat Surgery, Northwick Park Hospital, London
C Saxby
Affiliation:
Department of Ear, Nose and Throat Surgery, Northwick Park Hospital, London
P Coyle
Affiliation:
ENT Surgery Department, Addenbrooke's Hospital, Cambridge, UK
A Armstrong
Affiliation:
Plastic Surgery Department, Stoke Mandeville Hospital, Aylesbury, UK
W Mohamid
Affiliation:
Department of Pathology, Stevenage District General Hospital, UK
G Mochloulis
Affiliation:
Department of ENT Surgery, Stevenage District General Hospital, UK
*
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
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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.

Keywords

EpistaxisCauteryCauterizationSilver NitrateElectrocautery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 10 , October 2019 , pp. 923 - 927
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

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.

References

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