Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: five-year follow up of a randomised, controlled trial

Robertson, Stuart; Kubba, Haytham

doi:10.1017/s0022215107001600

Cited by 18 publications

(15 citation statements)

References 5 publications

(9 reference statements)

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“…It has been shown that most of the children with recurrent epistaxis had ongoing bleeding five years later irrespective of the treatment type (antiseptic cream vs no treatment). It was hypothesized that repeated colonization was the cause of ongoing bleeding but nasal colonization was not evaluated in those patients with ongoing bleeding (9).…”

Section: Discussionmentioning

confidence: 99%

“…Despite the proven short-term efficacy of antiseptic cream, the majority of children have ongoing bleeding after five years. Repeated colonization is blamed as the cause of ongoing bleeding (9). The aim of the present study was to investigate the nasal bacterial colonization rate in pediatric epistaxis patients and its implications on nasal findings and response to treatment.…”

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confidence: 97%

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Nasal Bacterial Colonization in Pediatric Epistaxis: The Role of Topical Antibacterial Treatment

et al. 2016

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Background: Epistaxis is a common problem in childhood. It has been shown that children with recurrent epistaxis are more likely to have nasal colonization with Staphylococcus aureus. It has been suggested that lowgrade inflammation, crusting and increased vascularity due to bacterial colonization contributes to the development of epistaxis in children. Aims: This study aimed to investigate the nasal colonization and treatment outcome in pediatric epistaxis patients. Study Design: Retrospective cross-sectional study. Methods: Charts of the pediatric patients referred to our university hospital otolaryngology outpatient clinics for the evaluation of epistaxis were reviewed. The patients whose nasal cultures had been taken at the first clinical visit comprised the study group. Results: Staphylococcus aureus was the most common bacteria grown. The presence of crusting and hypervascularity was not dependent on the type of bacterial growth and there was no relation between hypervascularity and crusting of the nasal mucosa. Thirty-six patients were evaluated for the outcome analysis. Resolution of bleeding was not dependent on nasal colonization; in patients with colonization, there was no difference between topical antibacterial and non-antibacterial treatments. Conclusion: Despite the high colonization rates, topical antibacterial treatment was not found superior to nonantibacterial treatment. Our study does not support the belief that bacterial colonization results in hypervascularity of the septal mucosa causing epistaxis since no relation was found between nasal colonization, hypervascularity and crusting. The role of bacterial colonization in pediatric epistaxis need to be further investigated and treatment protocols must be determined accordingly.

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Section: Discussionmentioning

confidence: 99%

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confidence: 97%

Nasal Bacterial Colonization in Pediatric Epistaxis: The Role of Topical Antibacterial Treatment

et al. 2016

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“…Silver nitrate cautery to obliterate these vessels produces significant benefit in reducing the frequency of epistaxis [9] although the problem often recurs over the next few years [10]. The histopathological nature of these vessels is unknown.…”

Section: Introductionmentioning

confidence: 99%

The pathology of visible blood vessels on the nasal septum in children with epistaxis

Montague

Whymark

Howatson

et al. 2011

International Journal of Pediatric Otorhinolaryngology

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“…Use of local ointments for hydrating, moisturizing nasal mucosa and local antimicrobial ointments have been found to be effective in 65.2%-91% of pediatric IRE patients 5 - 14 which was compatible with our results (71.6%). On the contrary, Robertson and Kubba 17 found that in 65% of pediatric epistaxis patients treated with cream with/ without cautery for long periods of five years nasal bleeding persisted, and the rate was highest (77%) in patients treated with combined application of cautery and cream. The rates of complete resolution of nose bleeding during 8 weeks of follow-up period using 75% and 95% concentrations of silver nitrate stick were found to be 98% and 90%, respectively 4 .…”

Section: Discussionmentioning

confidence: 96%

Efficacy and Safety of Intranasal Medical Management in Pediatric Patients with Idiopathic Recurrent Epistaxis

Özdamar

Acar

2020

MMJ

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Objective:The goal of the study was to verify the efficacy and safety of topical medical treatment in idiopathic recurrent pediatric epistaxis patients by intranasal usage of both an antimicrobial and a moisturizing agent as a first-step management modality. Method: Sixty-seven out of 326 pediatric patients with idiopathic recurrent epistaxis selected on a chart review of follow-up were enrolled in the study. The study was designed as an analysis of two groups: one group included 35 individuals (52.2% of the total cohort) having a hyperemic nasal mucosa and the second group included 32 individuals (47.8% of the total cohort) having a hypervascular nasal mucosa on physical examination before treatment. Results: The study was performed with a total of 67 children (age range 3-17 years) including 36 males (53.7% of total cohort) and 31 females (46.3% of total cohort). The mean age was 9.78±4.09 years. There was not any statistically significant difference between the groups in terms of age, duration of follow-up and recurrence time of epistaxis (p>0.05). Recurrence of epistaxis was seen in 22.9% (8/35) of hyperemic nasal mucosa group and in 34.4% (11/32) of hypervascular nasal mucosa group (p>0.05). Conclusion:We advise the use of both an intranasal antimicrobial ointment and a mucosal moisturizing gel as an effective, noninvasive and easily applicable medical treatment option for pediatric patients with idiopathic recurrent epistaxis before more invasive methods of epistaxis control. ÖZAmaç: Çalışmanın amacı, idiyopatik rekürren pediyatrik epistaksis hastalarında topikal tıbbi tedavinin etkinliğini ve güvenliğini hem antimikrobiyal hem de nemlendirici bir ajanın intranazal uygulanmasının birinci basamak tedavi yöntemi olarak incelemektir. Yöntem: İzlemin hasta kayıtlarının gözden geçirilmesiyle seçilen idiyopatik tekrarlayan burun kanaması olan 326 pediyatrik hastanın 67'si çalışmaya dahil edildi. Çalışma iki grubun analizi olarak tasarlanmıştır: bir grupta hiperemik burun mukozasına sahip 35 pediyatrik hasta (toplam kohortun %52,2'si) ve ikinci grupta hipervasküler burun mukozasına sahip 32 pediyatrik hasta (toplam kohortun %47,8'i) tedaviden önce fizik muayeneleri yapılmış uygun hastalar olarak seçilmiştir. Bulgular: Çalışma 36 erkek (toplam kohortun %53,7'si) ve 31 kadın (toplam kohortun %46,3'ü) olmak üzere toplam 67 çocuk hasta (3-17 yaş arası) ile gerçekleştirildi. Yaş ortalaması 9,78±4,09 idi. Gruplar arasında yaş, takip süresi ve burun kanaması nüks süresi açısından istatistiksel olarak anlamlı fark yoktu (p>0,05). Hiperemik nazal mukoza grubunun %22,9'unda (8/35) ve hipervasküler nazal mukoza grubunun %34,4'ünde (11/32) burun kanaması nüksü görüldü (p>0,05). Sonuç: Daha invaziv epistaksis kontrol yöntemlerinden önce, idiyopatik tekrarlayan epistaksisi olan pediyatrik hastalar için hem intranazal antimikrobiyal merhem hem de mukozal nemlendirici jelin birlikte kullanımının etkili, invaziv olmayan ve kolayca uygulanabilir bir tıbbi tedavi seçeneği olarak kullanılmasını öneriyoruz.Cite as: Ozdamar OI, Ozbilen...

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Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: five-year follow up of a randomised, controlled trial

Abstract: The majority of children treated at our clinic for recurrent epistaxis had ongoing bleeding five years later. Despite the proven short-term efficacy of chlorhexidine-neomycin cream, few patients receive further courses of cream or are referred back to the clinic.

Cited by 18 publications

References 5 publications

Nasal Bacterial Colonization in Pediatric Epistaxis: The Role of Topical Antibacterial Treatment

Nasal Bacterial Colonization in Pediatric Epistaxis: The Role of Topical Antibacterial Treatment

The pathology of visible blood vessels on the nasal septum in children with epistaxis

Efficacy and Safety of Intranasal Medical Management in Pediatric Patients with Idiopathic Recurrent Epistaxis

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