Endoscopic evaluation of bleeding points in epistaxis: a cross sectional study

Baneesh A. B.


Background: Epistaxis is one of the most common emergencies that come to casualty department and of which some are difficult to treat. Rigid nasal endoscopy plays a paramount role in managing epistaxis. The present study was done to map bleeding points with regard to its location, to identify the common areas and to discover the hidden areas.

Methods: 56 patients with epistaxis were examined using nasal endoscope under local anaesthesia. Only those patients in whom, the cause for epistaxis could not be made out on anterior and posterior rhinoscopy were included in the study.  

Results: 18 (32%) patients had bleeding point in right side and 24 (42.8%) patients it was in left side. 51.7% patients had bleeding point located on medial wall of nasal cavity and 19.6% patients had bleeding points on lateral wall of nasal cavity.

Conclusions: Nasal endoscopy plays a vital role in management of epistaxis. Most common bleeding point locations are on septum, near middle turbinate area.


Epistaxis, Nasal endoscopy, Bleeding point, Cauterisation

Full Text:



Charles W, Flint PW. "Epistaxis." Cummings Otolaryngology - Head and Neck Surgery. Philadelphia, PA: Mosby Elsevier; 2010: 687

Klotz DA, Winkle MR, Richmon J, Hengerer AS. Surgical management of posterior epistaxis: a changing paradigm. Laryngoscope. 2002;112(9):1577-82.

Gleeson M, editor. Scott-Brown's Otorhinolaryngology: Head and Neck Surgery. Volume 1. 7th Ed. CRC Press; 2008: 1347-1348

Thornton MA, Mahesh BN, Lang J. Posterior epistaxis: identification of common bleeding sites. Laryngoscope. 2005;115(4):588-90.

Chiu TW, McGarry GW. Prospective Clinical Study of Bleeding Sites in Idiopathic Adult Posterior Epistaxis. Otolaryngol Head Neck Surg. 2016;137(3):390–3.

Varshney S, Saxena RK. Epistaxis: a retrospective clinical study. Indian J Otolaryngol Head Neck Surg. 2005;57(2):125-9.

Kumar MVV, Prasad KUR, Gowda PRB, Manohar SR, Chennaveerappa PK. Rigid Nasal Endoscopy in the Diagnosis and Treatment of Epistaxis. J Clin Diagn Res. 2013;7(5):831–3.

Gupta AS, Majumder L, Pal SS. A study of role of nasal endoscopy in the diagnosis and management of epistaxis. J Evol Med Dent Sci. 2017;6(16):1253-5.

Elwany S, Abdel-Fatah H. Endoscopic control of posterior epistaxis. J Laryngol Otol. 1996;110(05):432-4.

Safaya A, Venkatachalam VP, Chaudhary N. Nasal endoscopy-evaluation in epistaxis. Indian Journal of Otolaryngol Head Neck Surg. 2000;52(2):133-6.

Paul J, Kanotra SP, Kanotra S. Endoscopic Management of Posterior Epistaxis. Indian Journal of Otolaryngol Head Neck Surg. 2011;63(2):141-4.

Woodruff GH. Cardiovascular epistaxis and the naso‐nasopharyngeal plexus. Laryngoscope. 1949;59(11):1238-47.

Mahesh Babu M, Gowda B, Satish HS. Role of Rigid Nasal Endoscopy in the Diagnosis and Management of Epistaxis. IOSR J Dent Med Sci. 2014;13(3):40-5.