A clinical analysis of nasal endoscopic management for refractory epistaxis / 中国微创外科杂志

ABSTRACT

Objective To summarize the clinical experience of nasal endoscopic treatment for refractory epistaxis. Methods .A retrospective analysis was made on 258 patients with refractory epistaxis treated with intranasal endoscopic exploration and hemostatic treatment from January 1998 to December 2004 in this hospital. Results .Hemorrhage was found on the nasal septum and the lateral nasal wall in 118 and 47 patients, respectively. Nose bleeding resulted from intranasal tumor in 8 patients. The site of bleeding was not clearly identified in 85 patients. Of the 258 patients, 257 responded to the treatment (99.6%) and 1 died ( 0.4%).Recurrent bleeding occurred in 43 patients. The incidence of recurrent bleeding was significantly higher in patients with unknown bleeding sites than in clearly diagnosed patients (?2=17.689,P=0.000). Conclusions .The emphasis of nasal endoscopic treatment for refractory epistaxis should be laid on the initial management, during which the bleeding site should be carefully identified. For patients with repeated nose bleeding, a combination treatment, including endoscopic filling-up of the anterior nasal cavity, endoscopic embolization of anterior and posterior nose, or embolization of the internal maxillary artery, is necessary.