Avoidance Of Nasal Pack By Routine Use Of Nasal Endoscope In Initial Management Of Epistaxis

Introduction - This study was undertaken with the objective to know whether routine use of nasal endoscope in initial management of epistaxis can help to control bleeding without the need of nasal pack so as to achieve targeted haemostasis with minimal discomfort. Material and methods- We conducted a cross sectional study enrolling 21 patients who were treated with nasal pack in other centers within less than 6 hours from onset of bleeding but were still bleeding and were referred to ENTdepartment of our hospital with nasal pack in situ. Deliberate search for bleeding point was made and tried to control bleeding by direct methods. Result- In 19 patients bleeding point was localized precisely whereas in 2 patients it was not. We controlled bleeding in 17 patients by chemical cautery or bipolar diathermy. In 2 patients repacking was done with medicated ribbon gauge as bleeding point could not be localized and bleeding was diffuse. Miniature pack of gelfoam was used to pack the inferior meatus in one patient. One patient had a bleeding polyp which was excised endoscopically and haemostasis achieved. Overall 19 patients (90.47 percent) were managed by various direct therapies in our study. Conclusion- It is expected that routine use of nasal endoscope in initial management of epistaxis will help in accurate identication and good control of bleeding avoiding discomfort and complication of nasal packing.

Common Ear, Nose, and Throat Problems in Pediatric Age Group Presenting to the Emergency Clinic – Prevalence and Management: A Hospital-Based Study.

ENT-related diseases form a significant portion of ailments in pediatric age group. Many of them present in emergency clinics with acute symptoms requiring urgent management. A prospective study was carried out in the Department of ENT, Gauhati Medical College, Guwahati, Assam, in patients below 16 years of age, to determine the hospital prevalence of ENT emergencies in pediatric age group and their management protocol as followed in a tertiary center. Emergencies relating to ear were most common followed by nasal and pharyngoesophageal conditions. Foreign bodies were most common among aural and nasal emergencies. A considerable number of patients presented with faciomaxillary and orodental injuries. Although mortality is low in such emergency group, morbidity may be very high at times. In management of such emergencies, particularly where operative intervention is required, expertise of an ENT specialist is necessary.