OBJECTIVE: To evaluate the pattern of epistaxis and its treatment modalities in our set up.
DESIGN: A descriptive case series.
SETTING: Ear Nose Throat (ENT) department of Liaquat University Hospital Hyderabad, Sindh
during years 2001 to 2003.
METHODS: This study comprised of 350 cases of nose bleeding managed at ENT department.
Patients belonged to all ages from infancy to old, with different presentation and causes. Case
records of all these cases were analyzed retrospectively.
RESULTS: Majority of patients (63%) was male and 35.4% patients were between 16-30 years
age. Bleeding due to existing nasal pathology was seen in 140 cases. Nasal trauma as a cause
of epistaxis was present in 125 cases (35.7%), blood dyscrasia in 25 cases and 20 patients had
metabolic disorders. Among 280 cases (80%) anterior bleeding was present. One hundred cases
required immediate nasal packing to control the bleeding. Surgical procedures included nasal
ploypectomy and septoplasty in 15 cases each while rhinolith and foreign bodies were removed
in 15 and 25 cases respectively. Fifty cases were treated with immediate cauterization of the
bleeding point. In 15 cases with malignancy of nose and sinuses, initially radiotherapy was considered
to decrease the vascularity of tumors. Only 20 cases did not require any treatment except
cold sponging and direct digital pressure.
CONCLUSION: Epistaxis is not an ignorable emergency. It is the manifestation of multiple local
and other systemic disorders. To reduce the morbidity and mortality, appropriate management
is the key factor. The emergency department of all hospitals shall have proper equipment and
facilities to examine and manage the cases. Cauterization of bleeding point by hot wire or
chemical agent to stop the bleeding is still valuable in recurrent epistaxis.
Epistaxis. Treatment. Emergency.