Comparison of Blind Nasal Packing vs Endoscopic Control of Epistaxis in an Emergency Setting

Chhapola, Sunita; Matta, Inita; Marker, Pratima

doi:10.5005/jp-journals-10001-1056

Cited by 3 publications

(6 citation statements)

References 14 publications

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“…This technique can cause some problems such as pain and discomfort, septum necrosis, local infection, toxic shock syndrome, and the need for using antibiotics or analgesics. Some of these can cause irreversible and dangerous side effects [5,6]. Although in this study, all these side effects were not seen in the hospital or patients' follow up, some side effects such as intolerance and nausea were significantly more in ANP group.…”

Section: Discussioncontrasting

confidence: 55%

“…These nonsurgical procedures are preferred to control mild-to-moderate bleedings [27]. Using these methods, due to their convenience and less pain, are increasing in comparison to painful surgical methods and chemical cauterization [6]. In the present study, NG group showed lower pain during the procedure and higher patients' satisfaction in comparison to ANP group.…”

Section: Discussionmentioning

confidence: 45%

“…Today, on account of using anticoagulant drugs, the prevalence of epistaxis is on a rise [4]. However, therapeutic strategies are very different, and no defined guideline exists in epistaxis management [5,6]. A preferable procedure to control bleeding is nasal endoscopy, but since it is not available in all centers, nasal packing is still the most common applied technique [7].…”

Section: Introductionmentioning

confidence: 99%

“…Low-risk side effects such as pain and discomfort to high-risk side effects such as toxic shock syndrome can occur. This is inevitable as the nasal mucosa is a common site for infection and hospital environment, as well as devices, are often resistant to disinfectants [5][6][7][8][9]. Furthermore, in most hospitals, nasal bleeding control is done by general physicians who might not have the expertise to do this procedure [10].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A New Method of Epistaxis Management Using Nasal Gel: A Single Center, Randomized Clinical Trial

Torabi

Esfahani

Moeinaddini

et al. 2018

Asian J Pharm Clin Res

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Objective: Epistaxis is one of the common causes of patients' referral to the emergency departments. In the majority of cases, epistaxis is managed by traditional methods. We investigated the efficacy of nasal gel (NG) in comparison to anterior nasal packing (ANP) to stop mild-to-moderate anterior nasal bleeding. Methods:In this prospective, randomized clinical trial, patients were divided into two groups of ANP (n=60) and NG (n=40). We determined and compared the efficacy of treatment (bleeding stop time and recurrence), patients' satisfaction at discharge (length of stay in the hospital, pain during the procedure, and procedural time), and safety (less side effects) in both groups. Results:The procedural time ≤2 min was observed in 90% and 58.33 % of NG group and ANP group, respectively (p<0.001). Pain score during procedure ≤4 and patients' satisfaction ≥7 were, respectively, seen in 87.5% and 65% of NG group, but it was 43.33% and 41.7% in ANP group, respectively (p<0.001, p=0.02). The side effects in ANP group were 35%; however, no side effects were observed in NG group. Conclusion:In the management of mild-to-moderate anterior nasal bleeding although NG efficacy is equivalent to ANP, using NG may be more convenient and satisfactory for patients. In addition, the use of this gel may result in more safety and fewer side effects.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A New Method of Epistaxis Management Using Nasal Gel: A Single Center, Randomized Clinical Trial

Torabi

Esfahani

Moeinaddini

et al. 2018

Asian J Pharm Clin Res

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show abstract

“…With the advent of nasal endoscope, the diagnosis and treatment of epistaxis became easy. Nasal endoscope has superior lighting quality and magnification which give a detailed view of the nasal cavity and the covert areas of the nose situated in the deep crevices of the lateral nasal wall [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic evaluation and treatment of epistaxis – A prospective study

U.P

S.R

et al. 2016

Int J Med Res Rev

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Epistaxis is a common nasal symptom seen in all age groups. It often presents as an emergency. An attempt should always be made to find any local or systemic cause for it because epistaxis is a sign and not a disease per se. Objectives: To evaluate the local causes of epistaxis using rigid nasal endoscope for specific treatment planning. Methods: This was a prospective study which included 50 patients with epistaxis who attended the Otolaryngology outpatient department of SUT Academy of Medical Sciences, Trivandrum over a period of one year. Rigid nasal endoscopy under local anesthesia was done for these patients for whom both anterior and posterior rhinoscopy could not reveal any local causes. Results: Nasal endoscopy helped in finding the local causes for epistaxis. Epistaxis was more common in males (66%) and majority was in the age group of 21-30 years (46%). The causes were posterior deviation of nasal septum with spur (24%), bleeding points on the nasal septum (12%), rhinosporidiosis (10%), infected polyp (10%), deviated nasal septum with allergic rhinitis (8%), congested adenoids (8%), deviated nasal septum with sinusitis (4%), nasopharyngeal mass (4%), and miscellaneous conditions (6%). In 6% patients, no significant local cause was detected. All the patients were treated according to the endoscopic findings. Conclusion: Nasal endoscope is an important tool in diagnosis and treatment of local causes of epistaxis.

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Rigid Nasal Endoscopy in the Diagnosis and Treatment of Epistaxis

Kumar

Prasad²,

Gowda³

2013

JCDR

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Background and Objectives: Epistaxis is one of the common symptoms encountered in the Otorhinolaryngology department. Many times the cause for epistaxis is not found on anterior and posterior rhinoscopy. The present study was undertaken to assess the role of rigid nasal endoscope in the diagnosis and treatment of epistaxis, where normal anterior and posterior rhinoscopy did not reveal any specific finding.Methods: Fifty patients with epistaxis were studied using rigid nasal endoscope under local anaesthesia. Patients who were above 15 years with nasal bleeding and who were willing for rigid nasal endoscopy were included in the study. Patients less than 15 years were not included in the study because nasal endoscopy was difficult in them under local anaesthesia. Only those patients in whom, the cause for epistaxis could not be made out on anterior and posterior rhinoscopy were chosen for the study, this was done in order to remove the bias for nasal endoscopy. Results:The use of the nasal endoscope allowed diagnosis of bleeding points and treating them directly. Epistaxis was more in male patients especially in the 3 rd and after the 5 th decade. On endoscopic examination,the bleeding points were identified as coming from the crevices of the lateral nasal wall, posterior spur on the septum, posterior deviation of the septum with ulcer, congested polyps, enlarged and congested adenoids, scabs or crusts in the crevices of the lateral nasal wall and angiofibroma. Endoscope also helps in the treatment of epistaxis, which includes endoscopic selective nasal packing using gelfoam, endoscopic cautery or diathermy and endoscopic polypectomy. Other patients with adenoids, scabs and crusts and angiofibroma were managed on their merits. Interpretation and Conclusion:Nasal endoscopy helps not only in the localisation of the bleeding point but also in the treatment of those bleeding areas that are situated in the posterior and lateral part of the nose.

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Comparison of Blind Nasal Packing vs Endoscopic Control of Epistaxis in an Emergency Setting

Cited by 3 publications

References 14 publications

A New Method of Epistaxis Management Using Nasal Gel: A Single Center, Randomized Clinical Trial

A New Method of Epistaxis Management Using Nasal Gel: A Single Center, Randomized Clinical Trial

Endoscopic evaluation and treatment of epistaxis – A prospective study

Rigid Nasal Endoscopy in the Diagnosis and Treatment of Epistaxis

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