Epitaxis Surgery

Ishida, Ryoji; Yamada, Hiroyuki; Nishii, Shin-ichiro; Tokuriki, Toshiharu; Ishinaga, Hajime

doi:10.7248/jjrhi1982.41.4_345

Cited by 2 publications

(1 citation statement)

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“…1,7,11,[13][14][15]22 In our study, 75.0% of the epistaxis cases had bleeding from the Kiesselbach plexus, but the ratio of bleeding from the Kiesselbach plexus was low for rebleeding cases and hospitalization cases, and bleeding from the middle meatus, the olfactory cleft, and unknown source increased. The site of bleeding in refractory epistaxis includes the sphenopalatine artery, the descending palatine artery (the posterior end of the inferior nasal concha, the posterior end of the inferior meatus, and the middle meatus), and the anterior and posterior ethmoidal arteries (the canopy of middle nasal concha and the olfactory) 13,26 . Rupture of carotid artery pseudoaneurysms associated with paranasal fungus, such as Aspergillus, can lead to severe epistaxis, which could be life-threatening.…”

Section: Site Of Bleedingmentioning

confidence: 99%

A Study on 615 Cases of Idiopathic Epistaxis

Kida

Oka

Fushimi

et al. 2021

International Journal of Practical Otolaryngology

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Epistaxis is one of the most common complaints encountered in the field of otorhinolaryngology. Although hemostasis can be achieved by outpatient treatment in many cases, we have also encountered some difficult-to-treat patients who developed rebleeding or required admission and surgery. We conducted a retrospective analysis of the clinical features of 615 patients with idiopathic epistaxis who were seen at our hospital between 2012 and 2019. We analyzed the patient data and clinical factors associated with epistaxis, including the age, gender, month (season) of visit to our hospital, accompanying systemic complications, bleeding points, procedures used for treatment, history of rebleeding, and history of hospitalization. The patients with epistaxis were predominantly males in their 70s. In regard to the season of presentation, patients with epistaxis were encountered more frequently in the winter than in the summer. Most patients had initially been treated by electrocoagulation. Hypertension was the most common underlying disease. Rebleeding within 7 days after the primary treatment occurred in 11.5% (71/615) of patients. Analysis identified heart and liver disease and antithrombotic drug use as significant risk factors for rebleeding. Although in the overall subject population the bleeding point was most frequently observed in Kiesselbach plexus area, the bleeding point was observed more often in the middle nasal meatus or olfactory cleft in the patients with rebleeding. The most common indication of hospitalization was difficulty in hemostasis, and the bleeding point in most of the hospitalized cases was unknown or in the posterior nasal cavity. The analysis revealed that it may be important to attempt endoscopic hemostasis in patients in whom the bleeding point is identified in the posterior nasal cavity.

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