Experimental surgical treatment for recurrent epistaxis

Dano, Isaac; Dangoor, Eric; Sichel, Jean‐Yves; Eliashar, Ron

doi:10.1016/s0196-0709(98)90036-9

Cited by 7 publications

(7 citation statements)

References 7 publications

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“…The mechanism by which SEHP occurs in PHDs is unknown. With spontaneous hemorrhagic phenomena occurring commonly in the general population (up to 60% of patients develop epistaxis in their lifetime (51)(52)(53), although estimates of the prevalence of spontaneous ecchymosis and hematohidrosis are not available) and PHDs occurring in 11% of the population for patients with migraine (54) and 1% for patients with TACs (55), the simultaneous or near-simultaneous occurrence of SEHP and PHDs may be one of chance alone. However, it is also possible that SEHP is a rare feature of Among ecchymosis-migraine cohort, bleeding was ipsilateral to the site of pain in 67% and bilateral in 33% of reported cases.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous extracranial hemorrhagic phenomena in primary headache disorders: A systematic review of published cases

et al. 2016

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Background Head pain is a cardinal feature of primary headache disorders (PHDs) and is often accompanied by autonomic and vasomotor symptoms and/or signs. Spontaneous extracranial hemorrhagic phenomena (SEHP), including epistaxis, ecchymosis, and hematohidrosis (a disorder of bleeding through sweat glands), are poorly characterized features of PHDs. Aim To critically appraise the association between SEHP and PHDs by systematically reviewing and pooling all reports of SEHP associated with headaches. Methods Advanced searches using the PubMed/MEDLINE, Web of Science, Cochrane Library, Google Scholar, and ResearchGate databases were carried out for clinical studies by combining the terms "headache AND ecchymosis", "headache AND epistaxis", and "headache AND hematohidrosis" spanning all medical literature prior to October 10, 2015. Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology guidelines were applied. Results A total of 105 cases of SEHP associated with PHDs (83% migraine and 17% trigeminal autonomic cephalgias) were identified (median age 27 years, male to female ratio 1:2.3); 63% had epistaxis, 33% ecchymosis, and 4% hematohidrosis. Eighty-three percent of studies applied the International Classification of Headache Disorders diagnostic criteria. Eighty percent of the reported headaches were episodic and 20% were chronic. Twenty-four percent of studies reported recurrent episodes of SEHP. Conclusions Our results suggest that SEHP may be rare features of PHDs. Future studies would benefit from the systematic characterization of these phenomena.

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Section: Discussionmentioning

confidence: 99%

Spontaneous extracranial hemorrhagic phenomena in primary headache disorders: A systematic review of published cases

et al. 2016

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“…The resulting scarring and fibrosis in the perichondrium of the septum reduced the possibility of neovascularization and recurrent bleeding. An animal study performed by Dano et al [20] showed that fibrosis and the reduced vascularity of the nasal septal mucosa prevent future episodes of epistaxis. Levi et al [18] proposed that septoplasty without removal of the septal cartilage was efficacious in treating recurrent recalcitrant pediatric epistaxis because of the fibrosis and scarring of the causative vasculature on the mucosal flaps.…”

Section: Discussionmentioning

confidence: 99%

Hemostasis of idiopathic recurrent epistaxis in children with microwave ablation: a prospective pilot case series

Lou¹

2019

J of Otolaryngol - Head & Neck Surg

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ObjectiveWe evaluated microwave ablation (MWA) for treatment of idiopathic recurrent anterior epistaxis (RAE) in children, in terms of technical feasibility, efficacy, and safety.Study designA prospective pilot case series.SettingTertiary university hospital.MethodsChildren with idiopathic RAE were treated with endoscopic MWA and reevaluated at 1 and 4 weeks and at 6 months thereafter. The primary outcome was successful hemostasis on the day of the procedure. Secondary outcomes were the rebleeding rates after 1 and 4 weeks, and 6 months, and any complications.ResultsOf the 92 children with idiopathic RAE who met the inclusion criteria, the operation was interrupted in 7 children due to intraoperative noncooperation, and silver nitrate cautery was performed instead. All procedures were completed, and hemostasis was achieved within 10–20 s by MWA in 85 children. Two to four ablations were conducted. No recurrent epistaxis occurred and no severe MWA -related complications, such as septal perforation or synechiae formation, were observed at the 6-month follow-up.ConclusionsEndoscopic MWA is a feasible and safe technique for the treatment of idiopathic pediatric RAE in the clinical setting, especially those cases that do not respond to in-office chemical cautery.

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“…In 1998, an animal study performed by Dano et al showed that supraperichondrial dissection of the septum leads to reduced vascularity of the septal mucosa on histologic inspection. The author performed unilateral dissections on the septal mucosa of 16 laboratory rabbits and analyzed the number of blood vessels as well as the area occupied by those blood vessels compared to the opposite side, which functioned as a control.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of recalcitrant idiopathic epistaxis in children: Septoplasty as a surgical treatment

et al. 2016

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Experimental surgical treatment for recurrent epistaxis

Cited by 7 publications

References 7 publications

Spontaneous extracranial hemorrhagic phenomena in primary headache disorders: A systematic review of published cases

Spontaneous extracranial hemorrhagic phenomena in primary headache disorders: A systematic review of published cases

Hemostasis of idiopathic recurrent epistaxis in children with microwave ablation: a prospective pilot case series

Outcomes of recalcitrant idiopathic epistaxis in children: Septoplasty as a surgical treatment

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