Posterior epistaxis and the undeflatable Foley's urinary catheter balloon

Abstract

A rare complication relating to the use of a Foley catheter in the control of posterior epistaxis is described. The balloon failed to deflate after the catheter had been in place for 32 hours and per-oral removal was required.

Managing blocked foley catheter balloons when removing posterior nasal packs in epistaxis patients

“…6 There are many solutions in the case of catheter balloons blocked in urinary bladders. Solutions include overdistention of the balloon causing it to burst, 7 transection of the Foley catheter distal to the occlusion, 8 ultrasound-guided puncture of the balloon, 1 chemical degradation of the balloon, 5 use of a "harpoon" or a guidewire to clear the blockage, and bursting under endoscopic guidance. 5,9 These methods may be acceptable when dealing with a urinary catheter in the bladder.…”

Removing Nasal Packing in Epistaxis: What to Do in the Case of an Undeflatable Foley Catheter Balloon

“…The factors associated with undeflatable Foley catheter balloons are generally related to malfunctions in the catheter valve system, blockages in the balloon channel caused by foreign objects (either saline solution crystals or blood clots), prolonged catheterization, or tube collapse resulting from compression. 2 3 This latter mechanism is particularly relevant in otorhinolaryngology, because the instruments used to secure the Foley catheter in the nose may constrict and cause a lumen collapse in the Foley catheter.…”

“…Various methods have been described for removing the Foley balloon from the bladder: sectioning the Foley catheter, 2 ultrasound-guided percutaneous puncture, 3 insertion of a stiletto to unblock the catheter, 4 injection of ether or acetone into the balloon channel, 5 and bursting the balloon with the use of endoscopy for visualization. 6 …”

“…In the case of an undeflatable Foley catheter following treatment of epistaxis, Choy et al removed the Foley balloon from the nasopharynx through the patient's mouth using Lore optical nasopharyngeal biopsy forceps associated with posterior rhinoscopy performed using a 70-degree Hopkins telescope. 2 …”

Silicone Foley catheters outperform latex Foley catheters for post‐nasal packing: an in‐vitro study

“…Although specific devices have been developed for packing and securing a posterior bleed, the Foley catheter is more commonly used in practice, as it is always readily available in the emergency room setting. Problems arise from this method of packing if the balloon fails to deflate 1 . In the tight dimensions of the nasal cavity, removal can be technically challenging for the clinician and uncomfortable for the patient.…”