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Use of trans-septal mattress suture of Little's area for anterior epistaxis

Published online by Cambridge University Press:  26 October 2010

S K Nitek*
Affiliation:
Department of Normal and Clinical Anatomy, Medical University of Warsaw, Poland
J Wysocki
Affiliation:
Otolaryngology and Rehabilitation Clinic, Medical University of Warsaw, Poland
C S Niszczota
Affiliation:
Department of Normal and Clinical Anatomy, Medical University of Warsaw, Poland
*
Address for correspondence: Dr Stanisław Nitek, Department of Normal and Clinical Anatomy, Medical University of Warsaw, 02-004 Warsaw, Chałubińskiego 5, Poland E-mail: [email protected]

Abstract

Background:

In some cases of epistaxis, anterior packing and/or electrocoagulation are not sufficient and suturing is needed. However, standard suturing techniques are sometimes ineffective. This paper reports the use of a new kind of trans-septal mattress suture, based on regional vascular anatomy, in this clinical context.

Methods:

Four adult patients with haemorrhage in Little's area underwent standard suturing, but bleeding persisted. These patients were successfully treated with trans-septal mattress suturing, using four punctures around the haemorrhage site.

Results:

No relapses or complications were observed over a six-month follow-up period.

Conclusion:

In cases of persistent bleeding from Little's area, suturing should surround the bleeding area. The described suturing method is simple, efficacious and cheap.

Type
Short Communications
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Pallin, DJ, Chung, YM, McKay, MP, Emond, JA, Pelletier, AJ, Camargo, CA Jr. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med 2005;46:7781CrossRefGoogle ScholarPubMed
2Shaheen, OH. Arterial epistaxis. J Laryngol Otol 1975;89:1734Google Scholar
3Barsan, H. Submucosal Tissucol injections in recurrent epistaxis [in French]. Schweiz Rundsch Med Prax 1990;79:944–7Google ScholarPubMed
4Beran, M, Petruson, B. Transection of varicose vessels in the nasal mucosa of patients with reccurent epistaxis. A 2-year follow-up. Clin Otolaryngol 1986;11:369–72CrossRefGoogle Scholar
5Guarisco, JL, Cheney, ML, Ohene-Frempong, K, Le Jeune, FE, Blair, PA. Limited septoplasty as treatment for recurrent epistaxis in a child with Glanzmann's thrombasthenia. Laryngoscope 1987;97:336–68CrossRefGoogle Scholar
6Juselius, H. Epistaxis. A clinical study of 1724 patients. J Laryngol Otol 1974;88:317–27Google Scholar
7Adornato, SG. A new ligation approach to the management of chronic epistaxis. Ear Nose Throat J 2000;79:721CrossRefGoogle Scholar
8Adornato, SG. Epistaxis: new approach. Otolaryngol Head Neck Surg 2000;123:524CrossRefGoogle ScholarPubMed
9Cantor, WL. Are we all stupid? Ear Nose Throat J 2001;80:117Google Scholar
10ZhengHua, Z, Gang, F, BingWei, Z, JiaWen, C. Suturing of Little's area of the nasal septum for epistaxis. J Laryngol Otol 2009;123:787–8CrossRefGoogle ScholarPubMed
11Anggard, A. Capillary and shunt blood flow in the nasal mucosa of the cat. Acta Otolaryngol 1974;78:418–22Google Scholar
12Cauna, N, Hinderer, KH. Fine structure of blood vessels of the human nasal respiratory mucosa. Ann Otol Rhinol Laryngol 1969;78:865–79CrossRefGoogle ScholarPubMed
13Standring, S, ed. Gray's Anatomy, 39th edn.Edinburg, London, New York, Oxford, Philadelphia, St Louis, Sydney, Toronto: Elsevier Churchill Livingstone, 2005;572–3Google Scholar
14Ritter, FN. The vasculature of the nose. Ann Otol Rhinol Laryngol 1970;79:468–74CrossRefGoogle ScholarPubMed