Epistaxis: Prevailing Factors and Treatment

• Main Authors: Secchi, Myrian Marajó Dal, Indolfo, Maria Lucia Pozzobon, Rabesquine, Matheus Moro, Castro, Fabrício Barbosa de
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2009-12-01
• Series: International Archives of Otorhinolaryngology
• Subjects: Epistaxis; Treatment; Prevailing factors; Endoscopic surgery
• Online Access: http://www.arquivosdeorl.org.br/conteudo/acervo_eng.asp?Id=646

Introduction: The epistaxis is one the most frequent otorhinolaryngologic emergencies in the medical practice. It is a benign affection, but the refractory cases require hospital admission. Objective: To evaluate prevailing factors in patients with epistaxis and treatment. Form of study: Retrospective study. Method: 60 patients with diagnosis of epistaxis were evaluated and they needed hospital admission between 2005 and 2006. Results: The main prevailing factors were: Systemic arterial hypertension 36% (n= 22), trauma 16% (n=10) and coagulopathy 5% (n=3). The treatment was the use of nasal splint: anterior 58% (n=35) and antero-posterior 27% (n=16), the electrocauterization of the identified bloody point 7% (n=4), endoscopic arterial bandage 8% (n=5) in severe epistaxis. For the patients with antero-posterior splint with recurrence of bleeding in the first 24 hours (five patients), after clinical stabilization, an arterial bandage was indicated by endoscopic means; four patients had systemic arterial hypertension and in one patient no prevailing factor was identified. Conclusion: The main associated prevailing factors were systemic arterial hypertension, trauma and coagulopathy. The treatment depends on the type, severity and cause of bleeding, initially the anterior and antero-posterior splint for bleeding control. The early endoscopic arterial bandage is indicated in patients with severe epistaxis and prevailing factors, and prolonged admission and morbidities associated with nasal splint should be avoided.