Etiology, Management, and Outcome of Pediatric Epistaxis

Send, Thorsten; Bertlich, Mattis; Eichhorn, Klaus; Ganschow, Rainer; Schafigh, Darius; Horlbeck, Fritz; Bootz, Friedrich; Jakob, Mark

doi:10.1097/pec.0000000000001698

Cited by 16 publications

(33 citation statements)

References 30 publications

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“…A previous study reported that factors, such as chronic sinusitis, alcohol intake, and smoking, increase the risk of epistaxis in adults [ 11 ]. In children, epistaxis is seldom serious and is usually caused by digital trauma; it is largely self-limiting [ 25 ]. As children regularly attend school and engage in outdoor activities, environmental factors, such as weather and air conditions, have a greater influence on their health than on the health of adults [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Particulate Matter 10 (PM10) Is Associated with Epistaxis in Children and Adults

Kim

Kwak

Min

2021

IJERPH

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The impact of atmospheric concentration of particulate matter ≤10 μm in diameter (PM10) continues to attract research attention. This study aimed to evaluate the effects of meteorological factors, including PM10 concentration, on epistaxis presentation in children and adults. We reviewed the data from 1557 days and 2273 cases of epistaxis between January 2015 and December 2019. Eligible patients were stratified by age into the children (age ≤17 years) and adult groups. The main outcome was the incidence and cumulative number of epistaxis presentations in hospital per day and month. Meteorological factors and PM10 concentration data were obtained from the Korea Meteorological Administration. Several meteorological factors were associated with epistaxis presentation in hospital; however, these associations differed between children and adults. Only PM10 concentration was consistently associated with daily epistaxis presentation in hospital among both children and adults. Additionally, PM10 concentration was associated with the daily cumulative number of epistaxis presentations in hospital in children and adults. Furthermore, the monthly mean PM10 concentration was significantly associated with the total number of epistaxis presentations in the corresponding month. PM10 concentration should be regarded as an important environmental factor that may affect epistaxis in both children and adults.

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Section: Discussionmentioning

confidence: 99%

Particulate Matter 10 (PM10) Is Associated with Epistaxis in Children and Adults

Kim

Kwak

Min

2021

IJERPH

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“…There are many studies in the literature evaluating the causes and treatments of epistaxis in children. Most of these include examinations of specialties where patients are referred for further evaluation (5)(6)(7)(8). In other words, most of these patients are referred to these departments due to the need for further evaluation in primary care or emergency services.…”

Section: Introductionmentioning

confidence: 99%

“…However, most of these patients present to the emergency services due to the need for urgent medical intervention during or immediately after the bleeding, and the number of studies evaluating the cases who applied to the emergency department with epistaxis is very few (1,9). Many local such as digital trauma, sinusitis, rhinitis, mucosal dryness caused by nasal polyp or septum deviation, and systemic causes such as drugs, hypertension and coagulopathy are among the causes of epistaxis (6)(7). Although determining the etiology is important in planning and following the treatment; etiology varies according to the age of the patient and whether there is active bleeding (5,9).…”

Section: Introductionmentioning

confidence: 99%

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Is a Laboratory Evaluations Required in Every Case Admitting to the Pediatric Emergency Department with Epistaxis?

Güneysu

Güleryüz²,

ceylan

et al. 2021

Preprint

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Background: Epistaxis is a mostly self-limiting condition common among children and is rarely severe. In this study, it was aimed to evaluate the incidence, demographic characteristics, causes of bleeding and treatment methods of patients who applied to the Pediatric Emergency Department (PED) with epistaxis, and to determine in which cases a laboratory test should be used. Method: Admitted to Gazi University Faculty of Medicine, PED which provides trauma care and is a tertiary hospital, between January 1, 2019 and December 31, 2019, 452 patients aged 0-18 years who presented with epistaxis to any reason or secondary to systemic disease were analyzed retrospectively. Results: The annual incidence was found 1.23%. The median age was 63 months, 258 of the cases (57.1%) were male. It was found that the cases most frequently applied to the hospital in the autumn months (37.6%). Sixty of the patients (13.3%) had a chronic disease and 54 (11.9%) had a history of drug use. Bleeding time was less than 5 minutes in 75.2% and 84.4% of the bleeding was unilateral. Nasal bleeding is local in 73.4%; 4.7% of them developed due to systemic reasons. The most common cause of epistaxis; while they were trauma at the first 10 years of age, they were idiopathic causes after the age of 10 years. In 434 (96%) of the patients, epistaxis spontaneously stopped and there was no need for additional treatment. Conclusion: As a result of this study, it was concluded that laboratory tests should be performed in cases with chronic disease history, bilateral bleeding, active bleeding and nontraumatic epistaxis. The situation that causes epistaxis in the childhood age group should be determined with a good history and physical examination, laboratory tests should not be used in every patient. Key Words: pediatric emergency, epistaxis, laboratory examinations, complete blood count

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“…Chronic epistaxis may already occur in early childhood [4] and symptoms usually increase with age [5]. Unless treated in centers with experience in HHT, treatment is often limited to strategies applied in acute epistaxis [6].…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Blue Light Laser Treatment in Hereditary Hemorrhagic Telangiectasia

et al. 2020

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Background and Objectives: Hereditary hemorrhagic telangiectasia (HHT) is a hereditary condition that is associated with arteriovenous malformations. A common site for these malformations is the nasal mucosa, which is associated with severe epistaxis and debilitation for affected patients. We evaluated the efficacy and safety of blue light laser technology in treating these endonasal manifestations in a retrospective chart analysis. Additionally, we compared blue light laser technology to bipolar coagulation in an animal model. Study Design/Materials and Methods: We performed a retrospective chart analysis of all patients that were diagnosed with HHT and received endonasal blue light laser treatment between 10/2017 and 04/2019. In addition, we performed bipolar or blue light laser coagulation of all macroscopically visible vessels on thyroid gland lobes (n = 4) from Dunkin-Hartley Guinea Pigs. Hematoxylin-eosin (HE) staining was then used to visualize depth and area of coagulation surrounding these vessels. Results: One hundred and fifty-one treatments in 23 patients were analyzed. Under regular blue light laser treatment, quality of life (QOL), indicated on a visual analog scale from 1 to 10, gradually increased significantly from 5.6 ± 0.5 (before the first treatment) to 7.5 ± 0.9 (after the second treatment). Following this, QOL remained steady throughout additional treatments. Adverse effects were not recorded. HE staining showed that coagulation depth (162 ± 56 vs. 586 ± 192 µm) and area (74 ± 35 vs. 1015 ± 449 µm 2) were significantly lower after laser treatment. Conclusion: Blue light laser therapy is safe and efficient in treating HHT. Damage to the surrounding tissue is significantly lower compared with bipolar coagulation.

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Etiology, Management, and Outcome of Pediatric Epistaxis

Cited by 16 publications

References 30 publications

Particulate Matter 10 (PM10) Is Associated with Epistaxis in Children and Adults

Particulate Matter 10 (PM10) Is Associated with Epistaxis in Children and Adults

Is a Laboratory Evaluations Required in Every Case Admitting to the Pediatric Emergency Department with Epistaxis?

Safety and Efficacy of Blue Light Laser Treatment in Hereditary Hemorrhagic Telangiectasia

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