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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

Information

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

1Small, M, Murray, JA, Maran, AG. A study of patients with epistaxis requiring admission to hospital. Health Bull (Edinb) 1982;40:20–9Google Scholar
2Pope, LE, Hobbs, CG. Epistaxis: an update on current management. Postgrad Med J 2005;81:309–14Google Scholar
3Supriya, M, Shakeel, M, Veitch, D, Ah-See, KW. Epistaxis: prospective evaluation of bleeding site and its impact on patient outcome. J Laryngol Otol 2010;124:744–9Google Scholar
4Barr, GD. Silver nitrate cautery and epistaxis. Arch Emerg Med 1989;6:233Google Scholar
5Amin, M, Glynn, F, Phelan, S, Sheahan, P, Crotty, P, McShane, D. Silver nitrate cauterisation, does concentration matter? Clin Otolaryngol 2007;32:197–9Google Scholar
6Ahmed, A, Woolford, T. Endoscopic bipolar diathermy in the management of epistaxis: an effective and cost-efficient treatment. Clin Otolaryngol Allied Sci 2003;28:273–5Google Scholar
7Link, TR, Conley, SF, Flanary, V, Kerschner, JE. Bilateral epistaxis in children: efficacy of bilateral septal cauterization with silver nitrate. Int J Pediatr Otorhinolaryngol 2006;70:1439–42Google Scholar
8Lloyd, S, Almeyda, J, Di Cuffa, R, Shah, K. The effect of silver nitrate on nasal septal cartilage. Ear Nose Throat J 2005;84:41–4Google Scholar
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;28:368–70Google Scholar
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;75:81–4Google Scholar
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;153:851–6Google Scholar
12Felek, SA, Celik, H, Islam, A, Demirci, M. Bilateral simultaneous nasal septal cauterization in children with recurrent epistaxis. Int J Pediatr Otorhinolaryngol 2009;73:1390–3Google Scholar