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Epistaxis management: is medical intervention required for inactive epistaxis?

Year 2014, Volume: 24 Issue: 4, 211 - 216, 25.09.2014

Abstract

Objectives: This study aims to discuss the management and the follow-up approach in patients with epistaxis. Patients and Methods: A total of 367 patients with epistaxis 209 males, 158 females; mean age 52.6±18.3 years; range 18 to 85 years admitted to the Adult Emergency Department of a university hospital between January 2000 and December 2004 were retrospectively analyzed. Results: Of patients, 56.7% had an idiopathic bleeding. A significantly higher number of patients aged >50 years had high blood pressure on admission. Of 141 patients 38.49% presenting without bleeding on admission, 20 required medical intervention for recurrent epistaxis. Conservative approaches were effective in stopping bleeding in 97.8% patients. The hospitalization ratio was 5.7%. Conclusion: Our study result show that endonasal endoscopic mucosal cauterization is an effective method for resistantto-treatment cases and inactive bleeding on admission is not a restraint for further examination.

References

  • Pollice PA, Yoder MG. Epistaxis: a retrospective review of hospitalized patients. Otolaryngol Head Neck Surg 1997;117:49-53.
  • Mahmood S, Lowe T. Management of epistaxis in the oral and maxillofacial surgery setting: An update on current practice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:23-9.
  • Pope LE, Hobbs CG. Epistaxis: an update on current management. Postgrad Med J 2005;81:309-14.
  • Strachan D, England J. First-aid treatment of epistaxis- -confirmation of widespread ignorance. Postgrad Med J 1998;74:113-4.
  • McGarry GW, Moulton C. The first aid management of epistaxis by accident and emergency department staff. Arch Emerg Med 1993;10:298-300.
  • Tomkinson A, Roblin DG, Flanagan P, Quine SM, Backhouse S. Patterns of hospital attendance with epistaxis. Rhinology 1997;35:129-31.
  • Durr DG. Endoscopic electrosurgical management of posterior epistaxis: shifting paradigm. J Otolaryngol 2004;33:211-6.
  • Almeida GS, Diógenes CA, Pinheiro SD. Nasal endoscopy and localization of the bleeding source in epistaxis: last decade's revolution. Braz J Otorhinolaryngol 2005;71:146-8.
  • O’Donnell M, Robertson G, McGarry GW. A new bipolar diathermy probe for the outpatient management of adult acute epistaxis. Clin Otolaryngol Allied Sci 1999;24:537-41.
  • Rourke T, Tassone P, Philpott C, Bath A. ENT cases seen at a local ‘walk-in centre’: a one year review. J Laryngol Otol 2009;123:339-42.
  • Upile T, Jerjes W, Sipaul F, Maaytah ME, Singh S, Hopper C, et al. A change in UK epistaxis management. Eur Arch Otorhinolaryngol 2008;265:1349-54.
  • Tam S, Rotenberg B. Contemporary perspectives on the management of posterior epistaxis: survey of canadian otolaryngologists. J Otolaryngol Head Neck Surg 2011;40:249-55.
  • Eze N, Lo S, Toma A. Advice given to patients with epistaxis by A&E doctors. Emerg Med J 2005;22:724-5.
  • Knopfholz J, Lima-Junior E, Précoma-Neto D, Faria-Neto JR. Association between epistaxis and hypertension: a one year follow-up after an index episode of nose bleeding in hypertensive patients. Int J Cardiol 2009;134:e107-9.
  • Page C, Biet A, Liabeuf S, Strunski V, Fournier A. Serious spontaneous epistaxis and hypertension in hospitalized patients. Eur Arch Otorhinolaryngol 2011;268:1749-53.
  • Herkner H, Havel C, Müllner M, Gamper G, Bur A, Temmel AF, et al. Active epistaxis at ED presentation is associated with arterial hypertension. Am J Emerg Med 2002;20:92-5.
  • Lubianca Neto JF, Fuchs FD, Facco SR, Gus M, Fasolo L, Mafessoni R, et al. Is epistaxis evidence of end-organ damage in patients with hypertension? Laryngoscope 1999;109:1111-5.
  • Sharp HR, Rowe-Jones JM, Biring GS, Mackay IS. Endoscopic ligation or diathermy of the sphenopalatine artery in persistent epistaxis. J Laryngol Otol 1997;111:1047-50.
  • Ahmed A, Woolford TJ. Endoscopic bipolar diathermy in the management of epistaxis: an effective and cost-efficient treatment. Clin Otolaryngol Allied Sci 2003;28:273-5.
  • Elwany S, Abdel-Fatah H. Endoscopic control of posterior epistaxis. J Laryngol Otol 1996;110:432-4.
  • Thong JF, Lo S, Houghton R, Moore-Gillon V. A prospective comparative study to examine the effects of oral diazepam on blood pressure and anxiety levels in patients with acute epistaxis. J Laryngol Otol 2007;121:124-9.
  • Ho EC, Chan JY. Front-line epistaxis management: let's not forget the basics. J Laryngol Otol 2008;122:696-9.
  • Evans AS, Young D, Adamson R. Is the nasal tampon a suitable treatment for epistaxis in Accident & Emergency? A comparison of outcomes for ENT and A&E packed patients. J Laryngol Otol 2004;118:12-4.
  • Monte ED, Belmont MJ, Wax MK. Management paradigms for posterior epistaxis: A comparison of costs and complications. Otolaryngol Head Neck Surg 1999;121:103-6.

Burun kanaması tedavisi: Durmuş kanamaya bir tıbbi girişim gerekir mi?

Year 2014, Volume: 24 Issue: 4, 211 - 216, 25.09.2014

Abstract

Amaç: Bu çalışmada burun kanamalı hastaların tedavi ve izlem yaklaşımı tartışıldı. Hastalar ve Yöntemler: Ocak 2000 - Aralık 2004 tarihleri arasında bir üniversite hastanesinin erişkin acil sevisine başvuran burun kanamalı toplam 367 hasta 209 erkek, 158 kadın; ort. yaş 52.6±18.3 yıl; dağılım 18-85 yıl geriye dönük olarak incelendi. Bulgular: Hastaların %56.7’sinde kanama idiyopatikti. Elli yaş üzerindeki anlamlı sayıda fazla hastada başvuru sırasında hipertansiyon mevcuttu. Başvuru sırasında kanama saptanmayan 141 hastanın %38.49 20’sine tekrarlayan burun kanaması nedeniyle tıbbi girişimde bulunuldu. Konservatif yaklaşım, hastaların %97.8’inde kanamanın durdurulmasıyla etkili bulundu. Hastaneye yatış oranı %5.7 idi. Sonuç: Çalışma bulgularımız, tedaviye dirençli olgularda endonazal endoskopik mukoza koterizasyonunun etkili bir yöntem olduğunu ve başvuru sırasında kanama olmamasının ileri inceleme için engel olmadığını göstermektedir.

References

  • Pollice PA, Yoder MG. Epistaxis: a retrospective review of hospitalized patients. Otolaryngol Head Neck Surg 1997;117:49-53.
  • Mahmood S, Lowe T. Management of epistaxis in the oral and maxillofacial surgery setting: An update on current practice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:23-9.
  • Pope LE, Hobbs CG. Epistaxis: an update on current management. Postgrad Med J 2005;81:309-14.
  • Strachan D, England J. First-aid treatment of epistaxis- -confirmation of widespread ignorance. Postgrad Med J 1998;74:113-4.
  • McGarry GW, Moulton C. The first aid management of epistaxis by accident and emergency department staff. Arch Emerg Med 1993;10:298-300.
  • Tomkinson A, Roblin DG, Flanagan P, Quine SM, Backhouse S. Patterns of hospital attendance with epistaxis. Rhinology 1997;35:129-31.
  • Durr DG. Endoscopic electrosurgical management of posterior epistaxis: shifting paradigm. J Otolaryngol 2004;33:211-6.
  • Almeida GS, Diógenes CA, Pinheiro SD. Nasal endoscopy and localization of the bleeding source in epistaxis: last decade's revolution. Braz J Otorhinolaryngol 2005;71:146-8.
  • O’Donnell M, Robertson G, McGarry GW. A new bipolar diathermy probe for the outpatient management of adult acute epistaxis. Clin Otolaryngol Allied Sci 1999;24:537-41.
  • Rourke T, Tassone P, Philpott C, Bath A. ENT cases seen at a local ‘walk-in centre’: a one year review. J Laryngol Otol 2009;123:339-42.
  • Upile T, Jerjes W, Sipaul F, Maaytah ME, Singh S, Hopper C, et al. A change in UK epistaxis management. Eur Arch Otorhinolaryngol 2008;265:1349-54.
  • Tam S, Rotenberg B. Contemporary perspectives on the management of posterior epistaxis: survey of canadian otolaryngologists. J Otolaryngol Head Neck Surg 2011;40:249-55.
  • Eze N, Lo S, Toma A. Advice given to patients with epistaxis by A&E doctors. Emerg Med J 2005;22:724-5.
  • Knopfholz J, Lima-Junior E, Précoma-Neto D, Faria-Neto JR. Association between epistaxis and hypertension: a one year follow-up after an index episode of nose bleeding in hypertensive patients. Int J Cardiol 2009;134:e107-9.
  • Page C, Biet A, Liabeuf S, Strunski V, Fournier A. Serious spontaneous epistaxis and hypertension in hospitalized patients. Eur Arch Otorhinolaryngol 2011;268:1749-53.
  • Herkner H, Havel C, Müllner M, Gamper G, Bur A, Temmel AF, et al. Active epistaxis at ED presentation is associated with arterial hypertension. Am J Emerg Med 2002;20:92-5.
  • Lubianca Neto JF, Fuchs FD, Facco SR, Gus M, Fasolo L, Mafessoni R, et al. Is epistaxis evidence of end-organ damage in patients with hypertension? Laryngoscope 1999;109:1111-5.
  • Sharp HR, Rowe-Jones JM, Biring GS, Mackay IS. Endoscopic ligation or diathermy of the sphenopalatine artery in persistent epistaxis. J Laryngol Otol 1997;111:1047-50.
  • Ahmed A, Woolford TJ. Endoscopic bipolar diathermy in the management of epistaxis: an effective and cost-efficient treatment. Clin Otolaryngol Allied Sci 2003;28:273-5.
  • Elwany S, Abdel-Fatah H. Endoscopic control of posterior epistaxis. J Laryngol Otol 1996;110:432-4.
  • Thong JF, Lo S, Houghton R, Moore-Gillon V. A prospective comparative study to examine the effects of oral diazepam on blood pressure and anxiety levels in patients with acute epistaxis. J Laryngol Otol 2007;121:124-9.
  • Ho EC, Chan JY. Front-line epistaxis management: let's not forget the basics. J Laryngol Otol 2008;122:696-9.
  • Evans AS, Young D, Adamson R. Is the nasal tampon a suitable treatment for epistaxis in Accident & Emergency? A comparison of outcomes for ENT and A&E packed patients. J Laryngol Otol 2004;118:12-4.
  • Monte ED, Belmont MJ, Wax MK. Management paradigms for posterior epistaxis: A comparison of costs and complications. Otolaryngol Head Neck Surg 1999;121:103-6.
There are 24 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Mustafa Cenk Ecevit This is me

Taner Kemal Erdağ This is me

Seçil Uçar This is me

Nesibe Sönmez Demiryoğuran This is me

Ahmet Ömer İkiz This is me

Özgür Karcıoğlu This is me

Semih Sütay This is me

Publication Date September 25, 2014
Published in Issue Year 2014 Volume: 24 Issue: 4

Cite

APA Ecevit, M. C., Erdağ, T. K., Uçar, S., Sönmez Demiryoğuran, N., et al. (2014). Burun kanaması tedavisi: Durmuş kanamaya bir tıbbi girişim gerekir mi?. The Turkish Journal of Ear Nose and Throat, 24(4), 211-216.
AMA Ecevit MC, Erdağ TK, Uçar S, Sönmez Demiryoğuran N, İkiz AÖ, Karcıoğlu Ö, Sütay S. Burun kanaması tedavisi: Durmuş kanamaya bir tıbbi girişim gerekir mi?. Tr-ENT. September 2014;24(4):211-216.
Chicago Ecevit, Mustafa Cenk, Taner Kemal Erdağ, Seçil Uçar, Nesibe Sönmez Demiryoğuran, Ahmet Ömer İkiz, Özgür Karcıoğlu, and Semih Sütay. “Burun Kanaması Tedavisi: Durmuş Kanamaya Bir tıbbi girişim Gerekir Mi?”. The Turkish Journal of Ear Nose and Throat 24, no. 4 (September 2014): 211-16.
EndNote Ecevit MC, Erdağ TK, Uçar S, Sönmez Demiryoğuran N, İkiz AÖ, Karcıoğlu Ö, Sütay S (September 1, 2014) Burun kanaması tedavisi: Durmuş kanamaya bir tıbbi girişim gerekir mi?. The Turkish Journal of Ear Nose and Throat 24 4 211–216.
IEEE M. C. Ecevit, T. K. Erdağ, S. Uçar, N. Sönmez Demiryoğuran, A. Ö. İkiz, Ö. Karcıoğlu, and S. Sütay, “Burun kanaması tedavisi: Durmuş kanamaya bir tıbbi girişim gerekir mi?”, Tr-ENT, vol. 24, no. 4, pp. 211–216, 2014.
ISNAD Ecevit, Mustafa Cenk et al. “Burun Kanaması Tedavisi: Durmuş Kanamaya Bir tıbbi girişim Gerekir Mi?”. The Turkish Journal of Ear Nose and Throat 24/4 (September 2014), 211-216.
JAMA Ecevit MC, Erdağ TK, Uçar S, Sönmez Demiryoğuran N, İkiz AÖ, Karcıoğlu Ö, Sütay S. Burun kanaması tedavisi: Durmuş kanamaya bir tıbbi girişim gerekir mi?. Tr-ENT. 2014;24:211–216.
MLA Ecevit, Mustafa Cenk et al. “Burun Kanaması Tedavisi: Durmuş Kanamaya Bir tıbbi girişim Gerekir Mi?”. The Turkish Journal of Ear Nose and Throat, vol. 24, no. 4, 2014, pp. 211-6.
Vancouver Ecevit MC, Erdağ TK, Uçar S, Sönmez Demiryoğuran N, İkiz AÖ, Karcıoğlu Ö, Sütay S. Burun kanaması tedavisi: Durmuş kanamaya bir tıbbi girişim gerekir mi?. Tr-ENT. 2014;24(4):211-6.