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Management of posterior epistaxis with the use of the fibreoptic nasolaryngoscope

Published online by Cambridge University Press:  29 June 2007

D. J. Premachandra*
Affiliation:
Tunbridge Wells
*
D. J. Premachandra, F.R.C.S., Consultant E.N.T. Surgeon, James Paget Hospital, Great Yarmouth NR31 6LA.

Abstract

Posterior epistaxis is usually treated by repeated nasal packing and in failed situations by ligation of feeding arteries with considerable morbidity and mortality. The most logical approach should be location of the bleeding site and arrest of haemorrhage by local treatment. The exact location of the bleeding area can be identified in actively bleeding noses with the fibreoptic naso-laryngoscope and the bleeding arrested by chemical, or thermal cautery and in failed situations by using small nasal packs confined to the bleeding site. This approach to the management of posterior epistaxis is effective and reduces the duration of hospital stay. It significantly reduces the discomfort to the patient. The current practice of indiscriminate blind nasal packing in the hope of arresting nasal haemorrhage by incidental pressure on the bleeding site should be re-evaluated.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1991

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