Age-related clinical characteristics and differences of refractory nasal bleeding site / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To investigate the distribution and regularities of intractable nasal bleeding site in different aged patients.METHODS The clinical data of 149 patients with intractable epistaxis were reviewed respectively.RESULTS Of the 149 patients, 110 cases were male and 39 cases were female with a age ranged from 18 to 87 years. They were divided into young group (39y or less), middle age group(40~59 y) and elderly group(60y or older), and there were 36, 52 and 61 cases in each group respectively. Hemostasis was performed with local anesthesia or general anesthesia under nasal endoscope. There were 145 cases with definite bleeding site, and electrocautery or micropacking was used for stop the bleeding. There were 4 cases without definite bleeding site. The bleeding site was on the posterior fornix of inferior meatus in 22 cases(61%), posterosuperior of middle nasal meatus in 13 cases(36.1%) and olfactory cleft of nasal septum in one case(2.7%) in young group; The bleeding site was on the posterior fornix of inferior meatus in 23 cases(44.2%), posterosuperior of middle nasal meatus in 10 cases(19.2%) and olfactory cleft of nasal septum in 17 cases(32.7%) in the middle age group; In the elderly group, the bleeding site was on the olfactory cleft of nasal septum in 37 cases(60.6%), posterosuperior of middle nasal meatus in 15 cases(24.6%) and posterior fornix of inferior meatus in 7 cases(11.5%).CONCLUSION In patients with refractory nasal bleeding, the majority responsible vessel was sphenopalatine artery or its branches in young and middle-aged patient and branches of anterior/posterior ethmoidal artery in elderly patients. Along with the increase of age, the sphenopalatine artery branch bleeding decreased, but the branches of anterior/posterior ethmoidal artery bleeding increased.