Study of etiopathogenesis and management of epistaxis in tertiary care centre
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20232219Keywords:
Epistaxis, Little’s areaAbstract
Background: Epistaxis is one of the most commonly addressed complaints in patients visiting outpatient department of ENT. This study aimed to determine common etiologies and management of epistaxis in a Tertiary care centre.
Methods: This prospective descriptive study was conducted with 60 patients selected by consecutive sampling presented to our hospital with epistaxis between the years 2021-2022.
Results: Incidence of epistaxis was more in males (58.33%) with male to female ratio of 1.4:1. Most common age group was between 10-49 years (68.33%). The commonest etiology was idiopathic (30%). When the cause was present, trauma was the most common reason mainly in young adults (13.33%) followed by hypertension (11.67%). The most common site of epistaxis was noted in the anterior nasal cavity (45%) where Little’s area (20%) was the most common location. Most cases were managed by conservative non-surgical treatments alone (55%) like anterior and, or posterior nasal packing, chemical/ electro-cauterization, foreign body removal, and blood components transfusion. Almost an equal number of patients underwent Surgical management in our hospital (45%) as it is a tertiary care centre.
Conclusions: Epistaxis is an ENT emergency seen in all age groups, more common in adolescents and young adults, males are affected more than females. The cause of epistaxis was not known in most cases, i.e., Idiopathic. Most of the cases can be managed by non-surgical treatment. It is necessary for the treating doctor to accurately diagnose the etiology of the case, and bleeding site and treat accordingly.
References
Brown S. Otorhinolaryngology and head and neck surgery. London: Hodder Arnold; 2011;1:1169.
Stedmen S. The American Heritage, Medical Dictionary. USA: Houghton Miffin Company; 2002.
Watkinson JC. Epistaxis. 6th ed. Scott Brown’s otorhinolaryngology Head and Neck Surgery. Oxford: Butterworth Heinemann; 1998:942-61.
McGarry GW. Epistaxis. 7th ed. In: Scott-Brown’s Otorhinolaryngology Head and Neck Surgery. London: Hodder Arnold; 2008:1596-608.
Juselius H. ‘Epistaxis’ A clinical study of 1724 patients. J Laryngol Otology. 1974;317-32.
Mackenzie C. Little’s area or the Locus Kiesselbachii. J Laryngol. 1914;1:21-2.
Christensen NP, Smith DS, Barnwell SL, Wax MK. Arterial embolization in the management of posterior epistaxis. Otolaryngol Head Neck Surg. 2005;133(5): 748-53.
Varshney S, Saxena RK. Epistaxis: a retrospective clinical study. Indian J Otolaryngol Head Neck Surg. 2005;57(2):125-9.
Gilyoma JM, Chalya P. Etiological profile and treatment outcome of epistaxis at a tertiary care hospital in Northwestern Tanzania: a prospective review of 104 cases. BMC Ear Nose Throat Disord. 2011;11:8.
Corbridge RJ, Djazaeri B, Hellier A, Hadley J. A prospective randomized controlled trial comparing the use of merocel nasal tampons and BIPP in the control of acute epistaxis. Clin Otolaryngol Allied Sci. 1995; 20(4):305-7.
Ahmed A, Woolford TJ. Endoscopic bipolar diathermy in the management of epistaxis: an effective and cost-efficient treatment. Clin Otolaryngol Allied Sci. 2003; 28(3):273-5.
Vitek JJ. Idiopathic intractable epistaxis: endovascular therapy. Radiol. 1991;181(1):113-6.
Bent JP, Wood BP. Complications resulting from treatment of severe posterior epistaxis. J Laryngol Otol. 1999;113(3):252-4.
Kumar S, Shetty A, Rockey J, Nilssen E. Contemporary surgical treatment of epistaxis. What is the evidence for sphenopalatine artery ligation?. Clin Otolaryngol Allied Sci. 2003;28(4):360-3.
Vaiman M, Segal S, Eviatar E. Fibrin glue treatment for epistaxis. Rhinology. 2002;40(2):88-91.
Stankiewicz JA. Nasal endoscopy and control of epistaxis. Curr Opi Otolaryngol Head Neck Surg. 2004;12(1):43-5.