J Rhinol.  2018 Nov;25(2):75-79. 10.18787/jr.2018.25.2.75.

Efficacy of Endoscopic Electrocauterization for Recurrent Posterior Epistaxis

Affiliations
  • 1Departments of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. rhinochung@gmail.com

Abstract

BACKGROUND AND OBJECTIVES
To investigate the common site of recurrent epistaxis after initial intervention such as packing and cauterization had failed and to evaluate the efficacy of surgical endoscopic electrocautery. SUBJECTS AND METHOD: Retrospective review of 47 patients with recurrent and uncontrolled idiopathic epistaxis between October 1995 and March 2016. All patients underwent endoscopic examination in the operating room after hospitalization. We performed electrocautery when a bleeding site was found.
RESULTS
The most common sites of bleeding were the inferior meatus (28%), sphenoethmoid recess (23%), superior septum around the olfactory cleft (13%), and the posterior end of the middle turbinate (15%). There was no serious complication during the one week after surgery. In 46 (98%) patients, refractory epistaxis was successfully controlled. One patient had recurrent epistaxis after electrocautery and underwent endoscopic sphenopalatine artery ligation.
CONCLUSION
In patients with refractory idiopathic epistaxis after failure of first-line treatment, endoscopic examination through a surgical approach and electrocautery for suspected bleeding are effective.

Keyword

Epistaxis; Posterior bleeding; Electrocauterization
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