Epistaxis surgery
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Epistaxis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Epistaxis surgery On the Web |
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American Roentgen Ray Society Images of Epistaxis surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D.
Overview
Surgery is not the first-line treatment option for patients with epistaxis. Surgery is usually reserved for patients with either heavy active bleeding, recurrent epistaxis and non-compliant medical therapy. Most of the time no action is needed to stop epistaxis. In active bleeding nasal compression is the first line to stop bleeding. There are some surgery options to stop bleeding and nasal cautery is the most usual surgery procedure to stop nasal bleeding.
Surgery
Surgery is not the first-line treatment option for patients with epistaxis. Surgery is usually reserved for patients with either heavy active bleeding, recurrent epistaxis and non-compliant medical therapy.[1] [2]
- Nasal cautery
- Nasal balloon or Foley catheter:
- A nasal balloon or Foley catheter is a good options to control bleeding specially in posterior-epistaxis.
- Embolization and surgical arterial ligation:
Indications
- Surgery is not the first-line treatment option for patients with epistaxis. In active bleeding nasal compression is the first line to stop bleeding. When other procedures like nasal compression and some medical therapies could not stop bleeding, there are some surgery options to control bleeding.[1]
- When other procedures could not stop bleeding, embolization of bleeding artery and surgical arterial ligation are the best options.
Contraindications
- Endovascular embolization of the anterior and/or posterior ethmoid arteries is contraindicated, as they originate from the ophthalmic artery there is a risk of blindness with this procedure.[1][3]
| This algorithm developed and modified according to Epistaxis of Emergency Medicine Clinics of North America and Clinical Practice Nosebleed (Epistaxis) Guideline. This guideline was published in the January 2020 issue of the American Academy of Otolaryngology-Head and Neck Surgery. |
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References
- ↑ 1.0 1.1 1.2 Tunkel, David E.; Anne, Samantha; Payne, Spencer C.; Ishman, Stacey L.; Rosenfeld, Richard M.; Abramson, Peter J.; Alikhaani, Jacqueline D.; Benoit, Margo McKenna; Bercovitz, Rachel S.; Brown, Michael D.; Chernobilsky, Boris; Feldstein, David A.; Hackell, Jesse M.; Holbrook, Eric H.; Holdsworth, Sarah M.; Lin, Kenneth W.; Lind, Meredith Merz; Poetker, David M.; Riley, Charles A.; Schneider, John S.; Seidman, Michael D.; Vadlamudi, Venu; Valdez, Tulio A.; Nnacheta, Lorraine C.; Monjur, Taskin M. (2020). "Clinical Practice Guideline: Nosebleed (Epistaxis)". Otolaryngology–Head and Neck Surgery. 162 (1_suppl): S1–S38. doi:10.1177/0194599819890327. ISSN 0194-5998.
- ↑ Krulewitz, Neil Alexander; Fix, Megan Leigh (2019). "Epistaxis". Emergency Medicine Clinics of North America. 37 (1): 29–39. doi:10.1016/j.emc.2018.09.005. ISSN 0733-8627.
- ↑ Araujo Filho, Bernardo Cunha; Pinheiro-Neto, Carlos Diógenes; Ramos, Henrique Faria; Voegels, Richard Louis; Sennes, Luiz Ubirajara (2011). "Ligadura endoscópica da artéria etmoidal anterior: estudo de dissecção em cadáveres". Brazilian Journal of Otorhinolaryngology. 77 (1): 33–38. doi:10.1590/S1808-86942011000100006. ISSN 1808-8686.