Jasdeep Monga, Vishal Pathania
BACKGROUND
Epistaxis is the most common emergency in otorhinolaryngology. The usual treatment in most cases of anterior epistaxis and almost all cases of posterior epistaxis is nasal packing followed by either cauterization, embolization or ligation. This study has been undertaken to evaluate the use of nasal endoscopic cauterization as the first line treatment both in anterior as well as posterior epistaxis.
MATERIALS AND METHODS
The study consisted of total 36 patients, who presented with epistaxis. All patients were first managed with nasal endoscopy and endoscopic electrocautery. Only the patients in which bleeding point could not be located by initial endoscopy were managed by insertion of nasal packing. The discomforts and minor complications in patients undergoing successful endoscopic cauterization and in the patients who were taken for nasal packing were observed along with average stay of patient in the hospital.
RESULTS
Out of total 36 patients, 28 patients (78%) could be successfully managed directly by endoscopic cauterization without undergoing nasal packing and the obvious discomfort associated with it. The average length of hospital stay in the patients without nasal pack was 1.39 days while for patients who were managed by nasal packing the average length of hospital stay was around 3 days. The patients who underwent nasal packing, 5 (62%) had minor complications. While in patients with endoscopic treatment as first line management, no such complications were observed.
CONCLUSION
Along with a good success rate, endoscopic cauterization is very effective in reducing the nasal packing related complications and the duration of stay of patient in the hospital, thus reducing the cost of treatment as well. This makes endoscopic cauterization a better first line management for both anterior as well as posterior epistaxis.
