Nasal endoscope in posterior epistaxis: a preliminary evaluation.
ABSTRACT The findings of a preliminary, prospective evaluation of the role of endoscopy in the management of adult posterior epistaxis are presented. A cohort of patients managed by the endoscopic technique was compared with a control group managed by the traditional methods of nasal packing or epistaxis balloons. The endoscope allowed visualization and direct treatment of previously undiagnosed posterior bleeding points. Patients managed by the endoscopic technique had a significantly shorter duration of in patient stay than those managed by traditional methods.
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ABSTRACT: Posterior epistaxis management remains a challenge. Besides their traumatic character, the usual treatments may cause as much morbidity and even mortality as the underlying pathology. A technique of endoscopically guided monopolar selective cauterisation was introduced in Lausanne at the end of 1987. Since then, 163 patients with a posterior epistaxis have been treated in our department. For 139 of these, endoscopic monopolar cauterization was the first treatment applied. Haemostasis was achieved at the first attempt in 82% of cases. The total success rate, including early recurrences controlled by a new cauterization, was 92%. Endoscopic monopolar cauterization requires the ability to perform nasal endoscopy, but presents few disadvantages. This technique represents a selective, relatively atraumatic, rapid and effective treatment. Moreover, costs are much lower than those of other methods. In our opinion, endoscopic monopolar cauterization should be the treatment of choice for posterior epistaxis.Rhinology 07/1998; 36(2):59-61. · 2.78 Impact Factor
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ABSTRACT: Epistaxis is a common cause for Emergency Department (ED) visits. Approximately 60% of the population has at least one bleeding episode over the course of a lifetime, fortunately; only 6% of this group requires medical attention. Both conservative and surgical modalities have been used in the treatment of epistaxis. Conservative measures conventionally include cauterization of the bleeding site, anterior nasal packing (ANP) and posterior nasal packing (PNP). The aim of this study is to assess the efficacy of the various conservative treatment modalities. This study was conducted between December 2000 and April 2005 and comprised a total of 200 cases of epistaxis managed in the Department of Otorhinolaryngology, Royal Medical Services (Amman, Jordan). All patients were treated initially by conservative measures and four groups were categorized based on the treatment received. Group I: Cauterization of the bleeding site using 15% silver nitrate was tried in 154 (77%) patients, and was successful in 114 (74.02%) of them. Group II: anterior nasal packing was done in a total of 86 (43%) patients and was successful in 74 (86.04%). Group III: Posterior nasal packing was done in 12 (6%) cases and was successful in 11 (91.6%). Group IV: Embolization of the internal maxillary artery was done in one patient (0.5%) who had intractable epistaxis and the previous measures were unsuccessful to control it. This was effective in stopping the bleeding. This study supports the clinical usefulness of conservative management in the treatment of patients with epistaxis. Most cases were successfully managed with conservative medical management alone and surgical intervention with its potential complications may not be necessary in most cases and should be the last resort.
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ABSTRACT: The use of the rigid endoscope has been investigated in the management of 63 cases with posterior nasal obstruction. It was found to be a true advance in rhinology, since it visualizes and localizes the site of the obstruction which is classified into pre-choanal, and post-choanal. Moreover, the nasal endoscope allowed complete and safe removal of most of the obstructing lesions under direct endoscopic vision.The Journal of Laryngology & Otology 12/1992; 106(11):977-80. DOI:10.1017/S0022215100121516 · 0.70 Impact Factor