The aim of the study was to determine if petroleum jelly was an effective treatment for paediatric epistaxis. A single-blind, prospective, randomized controlled trial was undertaken in an otolaryngology outpatient clinic of a paediatric hospital from March 2001 to March 2002. A total of 105 children referred with recurrent epistaxis were randomized into the study, 52 into the treatment arm and 53 into the control arm. Children in the treatment arm applied Vaseline twice a day bilaterally for 4 weeks and were monitored for any bleeds for the next 4 weeks. Children in the control arm were simply given an 8-week appointment and the number of bleeds were monitored for the 4 weeks prior to their appointment. The outcome measure was the proportion of children in each group without nosebleeds in the preceding 4 weeks. Both groups were equally distributed in age, duration of symptoms and duration of each bleed. Fourteen of 51 (27.5%) patients of the treatment arm and 18 of 53 (34%) of the control arm did not bleed in the 4 weeks before review (chi-square test, P = 0.472). It can be concluded that Vaseline alone confers no benefit over simple observation in recurrent childhood epistaxis.
A MEDLINE search was used to identify articles involving all forms of turbinate surgery over a 35-year period. Five hundred and sixty-one papers were identified. Of these, 283 specifically detailed turbinate surgery. These demonstrated a marked increase in the number of papers detailing endoscopic and laser turbinate surgery in the last 5 years. No randomised controlled studies were identified describing inferior turbinate surgery for nasal obstruction or middle turbinate surgery for any cause. The evidence supporting the efficacy of these procedures remains debatable. Research in this field appears to be driven by technological advancement rather than by establishment of patient benefit. Properly conducted randomised controlled trials are required to establish whether there is a long-term patient benefit from these commonly performed operations.
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