Young's procedure in the treatment of epistaxis

Abstract

Intractable epistaxis associated with septal perforation is a difficult problem to treat, particularly if nose-picking appears to be associated. Two such cases are presented in which Young's procedure of nasal closure was used to prevent epistaxis. Although the procedure was fully successful in only one patient, we feel the procedure has a part to play in the management of such cases of epistaxis.

The Young's Procedure for Severe Epistaxis from Hereditary Hemorrhagic Telangiectasia

“…These reports have mostly consisted of case reports, with the largest reported series of 12 patients. [3][4][5][6] In the largest series, it is noted that after the Young's procedure patients are able to engage in more social activities and we sought to show the effect the Young's procedure has on the quality of life. In this series, using the GBI, we were able to quantify a successful improvement in patient quality of life after the procedure.…”

Treatment of severe refractory epistaxis in hereditary hemorrhagic telangiectasia using a two‐flap nasal closure method

“…Based on previously shown efficacy 10-15 of reduction in epistaxis severity and increased quality of life it is our belief that nasal closure is underutilized. A commonly heard phrase postoperatively from our patients is “I have my life back.” This stems from the fact that these patients no longer have the uncertainty of severe, spontaneous, uncontrolled epistaxis.…”

“…Surgical closure of the nares has demonstrated effectiveness in preventing epistaxis 10-15 in patients who do not respond to other treatments or fail to achieve long-term resolution. Nasal closure, or Young's procedure, was first described for atrophic rhinitis in 1967 16 and applied to HHT patients for epistaxis in 1991.…”

“…Nasal closure, or Young's procedure, was first described for atrophic rhinitis in 1967 16 and applied to HHT patients for epistaxis in 1991. 10 The current standard Young's procedure is a modification of the original HHT nasal closure first reported by Lund and Howard. 12 This modified closure may be combined with lateral alotomy to create an additional internal flap closure.…”

Medical trivia

“…He continued, “Nose picking, or more accurately rhinotillexomania, is a recognised aetiology for intractable epistaxis 1. Historically, Wilbur Leakey discovered in the 1970s the first surviving written record of nose picking in Egypt.…”