Retrospective Clinical Study on Epistaxis

Clinical Study on Epistaxis

Keywords: Epistaxis, Anterior nasal packing, Bipolar Cauterization

Abstract

Background: Epistaxis is bleeding through nose. It is most common emergency situation in ENT that is disastrous to the patient and troublesome to treat for doctors. It is seen that 60% population experiences epistaxis in their life time and only 6% went to take consultation. The study  aims to evaluate incidence, etiology, provoking factors and cost effective management. Subjects and Methods: A 3 years retrospective study between September 2015 to August 2018 carried out in Anugarah Narayan Magadh Medical College & Hospital, Gaya on 98 admitted epistaxis patients. Results: Total 11,667 patients came in ENT department among them 2,723 patients with nasal complain. Incidence was0.84% among all cases and 3.6% among nasal problems. No obvious cause seen in 34 cases (34.23%) then cardiovascular cause in 32 cases (32.65%) then infection in19.32% and lastly by trauma in 5.68%. Maximum patients in 40-50 years age group 36% and minimum in 70-80 years 1%. Most patients belong to urban76 cases (77.27%) and middle age 36 cases (36.36%). Males are more prone 57 cases (57.95%) with ratio 1.39:1. Mostly in January-March months 45 cases (46.59%). Most patients came with unilateral epistaxis 86 cases (87.5%). About 26cases (26.14%)came with single episode whom urgent treatment required. Well managed with Nonsurgical method to 85 patients (86.73%) by anterior nasal packing (ANP) in 43 cases (43.87%) and chemical cauterization to 19 cases(19.30%) while surgical treatment given to 13 patients (13.26%).Some required electrocauterization 16 cases (16.32%) with bipolar. Mean hospital stay length 3.2 days. Blood transfusion required in 7cases (7.14%). Conclusion: Cost effectively anterior nasal packing is best conservative indirect method and electrocauterization is very effective direct method.

Downloads

Download data is not yet available.

References

Beck R, Sorge M, Schneider A, Dietz A. Current Approaches to Epistaxis Treatment in Primary and Secondary Care. Dtsch Arztebl Int. 2018;115(1-2):12–22.

İsmi O, Vayisoğlu Y, Özcan C, Görür K, Ünal M. Endoscopic Sphenopalatine Artery Ligation in Posterior Epistaxis: Retro- spective Analysis of 30 Patients. Turk Arch Otorhinolaryngol. 2016;54(2):47–52.

Manickam A, Ghosh D, Saha J, Basu SK. An Aetiopathological Study on Epistaxis in Adults and its Management. Bengal J Otolaryngol Head Neck Surg. 2015;23(1):12–17.

Safaya A, Venkatchalam VP, Choudhary N. Nasal Endoscopy evaluation in epistaxis. Ind J Otolaryngol Head Neck Surg. 2000;52:133–139.

Monjas-Cánovas I, Hernández-García I, Mauri-Barberá J, Sanz-Romero B, Gras-Albert JR. Epidemiology of epistaxis admitted to a tertiary hospital. Acta Otorrinolaringologica. 2010;61(1):41–47. Available from: https://dx.doi.org/10.1016/s2173-5735(10)70007-7.

Chattopadhyay PK. Evaluation of Symptoms in Cases of Otitis Media - A Clinical Study. Asian J Med Res. 2019;8(2):1–03.

Wang L, Vogel DH. Posterior Epistaxis: Comparison of Treatment. Otolaryngol Head Neck Surg. 1981;89(6):1001– 1006. Available from: https://dx.doi.org/10.1177/019459988108900624.

Kennedy DW. Functional Endoscopic Sinus Surgery: Technique. Archives Otolaryngol Head Neck Surg. 1985;111(10):643–649. Available from: https://dx.doi.org/10.1001/archotol.1985.00800120037003.

Dixon JA, Parlein JL. Laser Photocoagulation in HHT. Otolaryngol Head Neck Surg. 1981;89:204–204.

Rosnagle RS, Yanagisawa E, Smith HW. SPECIFIC VESSEL LIGATION FOR EPISTAXIS: SURVEY OF 60 CASES. Laryngoscope. 1973;83(4):517–526. Available from: https://dx.doi.org/10.1288/00005537-197304000-00008.

Sehaitkin B, Strauss M, Houck JR, Hershey PA, Epistaxis. Medical versus surgical therapy; A comparison of efficacy, complications, and economic considerations. Laryngoscope. 1987;97:1392–1398.

Raushan EA, Kumar A. Traumatic Optic Neuropath: Is this the Ideal Management Protocol? Asian J Med Res. 2019;8(4):1–3.

Pollice P, Yoder M. Epistaxis: A retrospective review of hospitalized patients. Otolaryngol Head Neck Surg. 1997;117(1):49–53. Available from: https://dx.doi.org/10.1016/s0194-5998(97)70205-5.

Philip AP, Milton GY. Epistaxis: A retrospective review of hospitalized patient. AJO Head Neck Surg. 1997;117(1):49– 53.

Arshad M, Ahmad Z, Liaqat A. Epistaxis: An experience with over 100 cases. Rawal Med J. 2007;32(2):142–147.

Villwock J, Jones K. Recent trends in epistaxis management in the United States. JAMA Otolaryngol Head Neck Surg. 2008;(12):1279–84.

Kuhn A, Hallberg OE. Epistaxis :An experience with over 100 cases. Arch Otolaryngol. 1955;62:130–130.

Maurer JJ, Miles M. Epidemiology of epistaxis admitted to tertiary hospital. J Neurosurg. 1961;18:837–837.

Monux A, Tomás M, Kaiser C, Gavilán J. Con- servative management of epistaxis. J Laryngol Otol. 1990;104(11):868–870. Available from: https://dx.doi.org/10.1017/s0022215100114203.

Juselius H. Epistaxis a clinical study of 1,724 patients. J Laryngol Otol. 1974;88(4):317–327. Available from: https://dx.doi.org/10.1017/s0022215100078749.

Published
2020-05-26