Epistaxis management - our point of view and literature review

Abstract

Nasal haemorrhage or epistaxis is the most common otolaryngologic emergency. It affects about 60% of the population and a percentage of 6% do not cease spontaneously, medical approach being needed.The management of epistaxis varies depending on its severity and etiology. The therapeutic conduct of this ENT emergency is based on three main principles: 1. local haemostasis; 2. detection and ceasing of the cause; 3. evaluation and correction of hypovolemia if necessary. Haemostasis can be done by chemical or electric cauterisation after identifying the bleeding source, by nasal packing, by endoscopic or external surgery or, in special cases, when none of the above methods returns any results, embolization. The current paper emphasizes our experience and a brief literature concerning epistaxis management in patients presented in the Emergency Room, in chronic cases of vascular intranasal tumors with recurrent bleeding, in iatrogenic haemorrhages, and none of the least we will bring into discussion the treatment applied for patients diagnosed with hereditary hemorrhagic telangiectasia.

Clinical Profile of Filipino Patients with Epistaxis in a University Hospital

“…Epistaxis, defined as an acute hemorrhage from the nostril, nasal cavity or nasopharynx is considered the most common otorhinolaryngologic emergency affecting up to 60% of the population in their lifetime with up to 6% warranting medical attention. 1,2 In this retrospective review of records, epistaxis was noted to be more common in men with a male to female ratio of 1.98:1. Globally, there is a male preponderance in epistaxis as shown in different studies as well.…”

“…Electrocautery has a reported efficacy of 90%. 2 When done inside the operating room under general anesthesia, patient safety and comfort is ensured and this can be easily performed by a trained physician. Arterial ligation is necessary only in intractable cases of epistaxis when all measures fail.…”