Complications of Postnasal Packing for Epistaxis

Aj, Kuhn; Oe, Hallberg

doi:10.1001/archotol.1955.03830010064009

Cited by 12 publications

(4 citation statements)

References 5 publications

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“…Anterior and posterior nasal packing has gained wide acceptance as a means of treating epistaxis. However, it has the potential for creating several local and systemic complications (Kuhn, 1955;Buchalter and Yanagisawa, 1968;Herzon, 1971). One of the most serious complications of nasal packing is arterial hypoxia and hypercapnia (Cassisi et al, 1971;Cvetnic etal., 1979), which has been attributed to hyperventilation (Lin and Orkin, 1979;Cvetnic etal., 1981); to sedation and aspiration (Jackobs et al, 1981) and to changes in pulmonary mechanics with increased pulmonary resistance and reduced lung compliance (nasopulmonary reflex) (Ogura etal., 1973).…”

Section: Discussionmentioning

confidence: 99%

Pneumatic nasal catheters:

Elwany¹,

Kamel

Mekhamer

1986

J. Laryngol. Otol.

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Section: Discussionmentioning

confidence: 99%

Pneumatic nasal catheters:

Elwany¹,

Kamel

Mekhamer

1986

J. Laryngol. Otol.

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“…Anterior-posterior nasal packing is fast becoming unpopular because it is found to be associated with prolonged hospital stay and thereby increased cost, (Montgomery et al, 1970;Rosnagle, 1973;McDonald and Pearson, 1980;Small and Maran, 1984), extreme discomfort (Montgomery and Reardon, 1980), increased mor- bidity (Kuhn and Hallberg, 1955) and hypoxaemia, (Cassisi etai, 1971), which, in the elderly and those with cardiopulmonary disease, can have serious repercussions, such as myocardial infarction (McDonald and Pearson, 1980), or death (Cassisi et al, 1971;Montgomery and Reardon, 1980). Because of this, arterial ligation, but more especially IMAL has been recommended, in the management of posterior intractable epistaxis (Montgomery and Reardon, 1980;Wang and Vogel, 1981;Small and Maran, 1984).…”

Section: Discussionmentioning

confidence: 99%

Combined internal maxillary and anterior ethmoidal arterial occlusion: the treatment of choice in intractable epistaxis

Singh¹,

Med²

1992

J. Laryngol. Otol.

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Whilst it is generally accepted that the standard management for anterior or benign epistaxis is either cautery or anterior nasal packing, that of posterior or intractable epistaxis remains controversial. Various modalities of treatment, ranging from posterior nasal packing to arterial ligation and embolization, have been advocated but none have been unanimously accepted as the treatment of choice.The purpose of this paper was to determine the efficacy of internal maxillary arterial ligation versus combined internal maxillary arterial ligation and anterior ethmoid arterial coagulation in intractable epistaxis.Over a six year period, from 1985 to 1990,454 patients were admitted and treated for epistaxis. Forty-seven patients were diagnosed as having intractable epistaxis on the basis that the epistaxis failed to settle on anterior nasal packing. They were moved to the next step in management, which was combined anterior and posterior nasal packing. There were 30 failures, one was found to have choriocarcinoma of the maxilla, and was treated wtih cytotoxics, and the other 29 were moved to the next step, which was arterial ligation. Fifteen patients had internal maxillary arterial ligation, and 14 combined internal maxillary arterial ligation and anterior ethmoidal arterial coagulation.Large windows were created in both the anterior and posterior walls of the maxillary sinuses and all identifiable branches of the internal maxillary artery were dissected out carefully and two medium size ligating clips were placed over the main trunk, the sphenopalatine and the descending palatine branches. Single clips were placed on all other identifiable branches. Coagulation of the anterior ethmoidal artery was performed with a bipolar cautery. There were three (20 per cent) failures in the internal maxillary arterial ligation group and none in the combined internal maxillary arterial ligation and anterior ethmoidal arterial coagulation group. Furthermore, the three failures were successfully treated with anterior ethmoidal arterial coagulation. The conclusion is that combined internal maxillary and anterior ethmoidal arterial occlusion is the treatment of choice in intractable epistaxis.

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“…This double application of a single intranasal pack is feasible because of the practically parallel dis¬ tribution of the septal branches to the lateral nasal wall branches. 6. The same single packing should be anchored at an immovable posterior fulcrum (Figs.…”

Section: And 2)mentioning

confidence: 99%

A Bilateral Posterior Intranasal Pack: An Evaluation of Various Types of Postnasal Packing

Gidoll¹

1959

Archives of Otolaryngology - Head and Neck Surgery

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Complications of Postnasal Packing for Epistaxis

Cited by 12 publications

References 5 publications

Pneumatic nasal catheters:

Pneumatic nasal catheters:

Combined internal maxillary and anterior ethmoidal arterial occlusion: the treatment of choice in intractable epistaxis

A Bilateral Posterior Intranasal Pack: An Evaluation of Various Types of Postnasal Packing

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