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Ding G, Gao X, Tan Y, Hao Z, Wang X, Zhang C, Deng A. Local application of silver nitrate as an adjuvant treatment before deep lamellar keratoplasty for fungal keratitis poorly responsive to medical treatment. Front Med (Lausanne) 2024; 10:1292701. [PMID: 38317754 PMCID: PMC10838974 DOI: 10.3389/fmed.2023.1292701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/11/2023] [Indexed: 02/07/2024] Open
Abstract
Objective The purpose of this study is to evaluate the efficacy and safety of the local application of silver nitrate (LASN) as an adjuvant treatment before deep lamellar keratoplasty (DLKP) for fungal keratitis responding poorly to medical treatment. Methods A total of 12 patients (12 eyes) with fungal keratitis responding poorly to medical treatment (for at least 2 weeks) were included. LASN was performed using 2% silver nitrate, the ulcer was cleaned and debrided, and then, the silver nitrate cotton stick was applied to the surface of the ulcer for a few seconds. The effect of LASN was recorded. The number of hyphae before and after treatment was determined by confocal microscope. After the condition of the ulcer improved, DLKP was performed. Fungal recurrence, best-corrected visual acuity (BCVA), loose sutures, and endothelial cell density (ECD) were recorded in detail. Results Clinical resolution of corneal infiltration and edema was observed, and the ulcer boundary became clear in all 12 patients after 7-9 days of LASN. Confocal microscopy showed that the number of hyphae was significantly reduced. Ocular pain peaked on days 1 and 2 after treatment, and 9 patients (75%, day 1) and 1 patient (8.3%, day 2) required oral pain medication. During the follow-up period after DLKP, no fungal recurrence and loose sutures were observed. After the operation, the BCVA of all patients improved. The mean corneal ECD was 2,166.83 ± 119.75 cells/mm2. Conclusion The LASN was safe and effective and can be well tolerated by patients. Eye pain can be relieved quickly. LASN as an adjuvant treatment before DLKP might be a promising therapeutic strategy.
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Affiliation(s)
- Gang Ding
- Department of Ophthalmology, The Jinan Second People's Hospital, Jinan, China
| | - Xin Gao
- Department of Ophthalmology, The Jinan Second People's Hospital, Jinan, China
| | - Yue Tan
- Department of Ophthalmology, The Jinan Second People's Hospital, Jinan, China
| | - Zhongkai Hao
- Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Ximing Wang
- Department of Ophthalmology, The Jinan Second People's Hospital, Jinan, China
| | - Chenming Zhang
- Department of Ophthalmology, The Jinan Second People's Hospital, Jinan, China
| | - Aijun Deng
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, Weifang, China
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Schafer AD, McNutt M, Fulmer A, Bourgeois T, Elmaraghy CA. Comparing recurrence between cautery techniques in pediatric epistaxis. Int J Pediatr Otorhinolaryngol 2024; 176:111779. [PMID: 37979255 DOI: 10.1016/j.ijporl.2023.111779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE To compare the risk of recurrent epistaxis between children treated with silver nitrate (SN) in the office or electrocautery (EC) in the operating room (OR). METHODS Patients aged 2-18 diagnosed with epistaxis (ICD R04.0) in 2018 and treated with SN or EC were retrospectively reviewed. Epistaxis laterality, history of nasal trauma, and personal or family history of a bleeding disorder were recorded. Patients with prior cautery or epistaxis secondary to a procedure were excluded. Recurrence was defined as initial encounter after cautery with documented epistaxis. Patients were followed up into 2022 to track onset of recurrence. Time to recurrence between SN and EC was compared with hazard curves with predictors for recurrence analyzed via Cox's proportional hazard regression. RESULTS Among 291 patients cauterized for epistaxis, 62 % (n = 181) received SN compared to 38 % (n = 110) who underwent EC. There was significantly higher risk of recurrence when treated with SN compared to EC (Hazard ratio 2.45, 95 % CI: 1.57-3.82, P < 0.0001). Median time to recurrence was not statistically different between techniques (6.39 months (SN) (IQR: 2.33, 14.82) vs. 4.11 months (EC) (IQR: 1.18, 20.86), P = 0.4154). Complication rates were low for both groups (1.16 % (SN) vs. 0 % (EC), P > 0.05). CONCLUSION Among patients with epistaxis, risk of recurrence is significantly higher in those cauterized with SN compared to EC. Time to recurrence is not significantly different between cautery techniques.
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Affiliation(s)
- Austin D Schafer
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Megan McNutt
- Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Amy Fulmer
- Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Tran Bourgeois
- Center for Surgical Outcomes Research, Nationwide Children's Hospital, Columbus, OH, USA
| | - Charles A Elmaraghy
- The Ohio State University College of Medicine, Columbus, OH, USA; Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
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Olgun Y, Aktas S, Sutay S, Ecevit MC. The Effect of Bevacizumab and Propranolol on Nasal Polyposis. Int J Clin Pract 2022; 2022:6174664. [PMID: 36304979 PMCID: PMC9581690 DOI: 10.1155/2022/6174664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the effects of bevacizumab and propranolol from the point of view of a possible antiangiogenic effect in a model of primary nasal polyp (NP) tissue culture. METHODS NP samples of 21 patients and normal healthy nasal mucosa samples of 7 patients were cultured. Samples were divided into four groups as follows (healthy nasal mucosa, NP without any treatment, NP treated with propranolol, NP treated with bevacizumab). Cultured tissues were formalin fixed and paraffin embedded. Tissue sections and immunohistochemical VEGF-A, angiopoietin-1 (Ang-1), and angiopoietin-2 (Ang-2) expressions were evaluated. ELISA was also performed for each one of them. RESULTS Both propranolol and bevacizumab significantly decreased the expressions of VEGF-A and Ang-1, and they significantly increased the expression of Ang-2 in comparison to the control NP group. In the healthy nasal mucosa group, no significant expression of VEGF-A was seen, a slight (+) Ang-1 expression, and a high (+++) Ang-2 expression were observed. CONCLUSION Bevacizumab and propranolol exert an antiangiogenic effect on NP tissues, mainly by decreasing VEGF-A and Ang-1 expression, increasing Ang-2 expression.
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Affiliation(s)
- Yuksel Olgun
- Dokuz Eylül University School of Medicine, Department of Otorhinolaryngology, Izmir, Turkey
| | - Safiye Aktas
- Dokuz Eylül University Institute of Oncology, Department of Basic Oncology, Izmir, Turkey
| | - Semih Sutay
- Dokuz Eylül University School of Medicine, Department of Otorhinolaryngology, Izmir, Turkey
| | - Mustafa Cenk Ecevit
- Dokuz Eylül University School of Medicine, Department of Otorhinolaryngology, Izmir, Turkey
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Yan T, Goldman RD. Recurrent epistaxis in children. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2021; 67:427-429. [PMID: 34127465 DOI: 10.46747/cfp.6706427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
QUESTION A child came to my clinic complaining of recurrent epistaxis with several episodes occurring every year since he was a toddler. The nosebleeds affect both nostrils, often lasting for an extended period of time and occurring in no apparent seasonal pattern. What interventions are safe and effective for recurrent epistaxis in children, and which patients warrant hematologic testing? ANSWER Epistaxis affects more than half of children by the time they are 10 years old, with 9% of children reported to have recurrent episodes. Most cases are of benign origin and will not require further workup. For those seeking intervention, nasal mucosal hydration, such as emollient application, or humidification resolves up to 65% of cases, and many novel interventions have shown promise in their respective initial studies. Standardized bleeding questionnaires have demonstrated usefulness in decision making for further coagulation studies, taking into account historical features including frequency, duration, bleeding site, seasonal correlation, and severity.
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Yan T, Goldman RD. [Not Available]. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2021; 67:430-432. [PMID: 34127466 PMCID: PMC8202752 DOI: 10.46747/cfp.6706430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Question Un enfant vient à ma clinique et se plaint d’une épistaxis récurrente, notamment de plusieurs épisodes par année depuis qu’il est tout petit. Les saignements de nez se produisent dans les 2 narines et durent souvent longtemps, sans qu’il y ait de tendances saisonnières apparentes. Quelles sont les interventions sûres et efficaces pour l’épistaxis chez les enfants, et chez quels patients des analyses hématologiques s’imposeraient-elles? Réponse L’épistaxis se produit chez plus de la moitié des enfants avant qu’ils aient atteint l’âge de 10 ans, et on rapporte que chez 9 % des enfants, les épisodes sont récurrents. Dans la plupart des cas, l’affection est d’origine bénigne et ne nécessitera pas d’investigation plus poussée. Pour ceux qui demandent une intervention, l’hydratation des muqueuses nasales, comme l’application d’émollients ou l’humidification, règle jusqu’à 65 % des cas, et de nombreuses nouvelles interventions se sont révélées prometteuses dans leurs études initiales respectives. Il a été démontré que des questionnaires normalisés sur les saignements sont utiles dans la prise de décisions sur la poursuite d’autres analyses de la coagulation, en tenant compte des caractéristiques historiques comme la fréquence, la durée, le site des saignements, les corrélations saisonnières et la gravité.
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Tunkel DE, Anne S, Payne SC, Ishman SL, Rosenfeld RM, Abramson PJ, Alikhaani JD, Benoit MM, Bercovitz RS, Brown MD, Chernobilsky B, Feldstein DA, Hackell JM, Holbrook EH, Holdsworth SM, Lin KW, Lind MM, Poetker DM, Riley CA, Schneider JS, Seidman MD, Vadlamudi V, Valdez TA, Nnacheta LC, Monjur TM. Clinical Practice Guideline: Nosebleed (Epistaxis). Otolaryngol Head Neck Surg 2020; 162:S1-S38. [PMID: 31910111 DOI: 10.1177/0194599819890327] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Nosebleed, also known as epistaxis, is a common problem that occurs at some point in at least 60% of people in the United States. While the majority of nosebleeds are limited in severity and duration, about 6% of people who experience nosebleeds will seek medical attention. For the purposes of this guideline, we define the target patient with a nosebleed as a patient with bleeding from the nostril, nasal cavity, or nasopharynx that is sufficient to warrant medical advice or care. This includes bleeding that is severe, persistent, and/or recurrent, as well as bleeding that impacts a patient's quality of life. Interventions for nosebleeds range from self-treatment and home remedies to more intensive procedural interventions in medical offices, emergency departments, hospitals, and operating rooms. Epistaxis has been estimated to account for 0.5% of all emergency department visits and up to one-third of all otolaryngology-related emergency department encounters. Inpatient hospitalization for aggressive treatment of severe nosebleeds has been reported in 0.2% of patients with nosebleeds. PURPOSE The primary purpose of this multidisciplinary guideline is to identify quality improvement opportunities in the management of nosebleeds and to create clear and actionable recommendations to implement these opportunities in clinical practice. Specific goals of this guideline are to promote best practices, reduce unjustified variations in care of patients with nosebleeds, improve health outcomes, and minimize the potential harms of nosebleeds or interventions to treat nosebleeds. The target patient for the guideline is any individual aged ≥3 years with a nosebleed or history of nosebleed who needs medical treatment or seeks medical advice. The target audience of this guideline is clinicians who evaluate and treat patients with nosebleed. This includes primary care providers such as family medicine physicians, internists, pediatricians, physician assistants, and nurse practitioners. It also includes specialists such as emergency medicine providers, otolaryngologists, interventional radiologists/neuroradiologists and neurointerventionalists, hematologists, and cardiologists. The setting for this guideline includes any site of evaluation and treatment for a patient with nosebleed, including ambulatory medical sites, the emergency department, the inpatient hospital, and even remote outpatient encounters with phone calls and telemedicine. Outcomes to be considered for patients with nosebleed include control of acute bleeding, prevention of recurrent episodes of nasal bleeding, complications of treatment modalities, and accuracy of diagnostic measures. This guideline addresses the diagnosis, treatment, and prevention of nosebleed. It focuses on nosebleeds that commonly present to clinicians via phone calls, office visits, and emergency room encounters. This guideline discusses first-line treatments such as nasal compression, application of vasoconstrictors, nasal packing, and nasal cautery. It also addresses more complex epistaxis management, which includes the use of endoscopic arterial ligation and interventional radiology procedures. Management options for 2 special groups of patients-patients with hereditary hemorrhagic telangiectasia syndrome and patients taking medications that inhibit coagulation and/or platelet function-are included in this guideline. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group. It is not intended to be a comprehensive, general guide for managing patients with nosebleed. In this context, the purpose is to define useful actions for clinicians, generalists, and specialists from a variety of disciplines to improve quality of care. Conversely, the statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. ACTION STATEMENTS The guideline development group made recommendations for the following key action statements: (1) At the time of initial contact, the clinician should distinguish the nosebleed patient who requires prompt management from the patient who does not. (2) The clinician should treat active bleeding for patients in need of prompt management with firm sustained compression to the lower third of the nose, with or without the assistance of the patient or caregiver, for 5 minutes or longer. (3a) For patients in whom bleeding precludes identification of a bleeding site despite nasal compression, the clinician should treat ongoing active bleeding with nasal packing. (3b) The clinician should use resorbable packing for patients with a suspected bleeding disorder or for patients who are using anticoagulation or antiplatelet medications. (4) The clinician should educate the patient who undergoes nasal packing about the type of packing placed, timing of and plan for removal of packing (if not resorbable), postprocedure care, and any signs or symptoms that would warrant prompt reassessment. (5) The clinician should document factors that increase the frequency or severity of bleeding for any patient with a nosebleed, including personal or family history of bleeding disorders, use of anticoagulant or antiplatelet medications, or intranasal drug use. (6) The clinician should perform anterior rhinoscopy to identify a source of bleeding after removal of any blood clot (if present) for patients with nosebleeds. (7a) The clinician should perform, or should refer to a clinician who can perform, nasal endoscopy to identify the site of bleeding and guide further management in patients with recurrent nasal bleeding, despite prior treatment with packing or cautery, or with recurrent unilateral nasal bleeding. (8) The clinician should treat patients with an identified site of bleeding with an appropriate intervention, which may include one or more of the following: topical vasoconstrictors, nasal cautery, and moisturizing or lubricating agents. (9) When nasal cautery is chosen for treatment, the clinician should anesthetize the bleeding site and restrict application of cautery only to the active or suspected site(s) of bleeding. (10) The clinician should evaluate, or refer to a clinician who can evaluate, candidacy for surgical arterial ligation or endovascular embolization for patients with persistent or recurrent bleeding not controlled by packing or nasal cauterization. (11) In the absence of life-threatening bleeding, the clinician should initiate first-line treatments prior to transfusion, reversal of anticoagulation, or withdrawal of anticoagulation/antiplatelet medications for patients using these medications. (12) The clinician should assess, or refer to a specialist who can assess, the presence of nasal telangiectasias and/or oral mucosal telangiectasias in patients who have a history of recurrent bilateral nosebleeds or a family history of recurrent nosebleeds to diagnose hereditary hemorrhagic telangiectasia syndrome. (13) The clinician should educate patients with nosebleeds and their caregivers about preventive measures for nosebleeds, home treatment for nosebleeds, and indications to seek additional medical care. (14) The clinician or designee should document the outcome of intervention within 30 days or document transition of care in patients who had a nosebleed treated with nonresorbable packing, surgery, or arterial ligation/embolization. The policy level for the following recommendation, about examination of the nasal cavity and nasopharynx using nasal endoscopy, was an option: (7b) The clinician may perform, or may refer to a clinician who can perform, nasal endoscopy to examine the nasal cavity and nasopharynx in patients with epistaxis that is difficult to control or when there is concern for unrecognized pathology contributing to epistaxis.
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Affiliation(s)
- David E Tunkel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Spencer C Payne
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Stacey L Ishman
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | | | | | | | - Rachel S Bercovitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | | | | | | | - Jesse M Hackell
- Pomona Pediatrics, Boston Children's Health Physicians, Pomona, New York, USA
| | | | | | | | - Meredith Merz Lind
- Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio, USA
| | | | | | - John S Schneider
- Washington University School of Medicine, St Louis, Missouri, USA
| | - Michael D Seidman
- AdventHealth Medical Group, Celebration, Florida, USA.,University of Central Florida, Orlando, Florida, USA.,University of South Florida, Tampa, Florida, USA
| | | | | | - Lorraine C Nnacheta
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Taskin M Monjur
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Lou ZC, Hong F, Lou ZH. Microwave ablation versus silver nitrate cautery for treating recurrent epistaxis in adolescents: A prospective, randomized case-control study. Int J Pediatr Otorhinolaryngol 2019; 121:41-45. [PMID: 30861426 DOI: 10.1016/j.ijporl.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/02/2019] [Accepted: 03/02/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To compare the outcomes of adolescent patients with recurrent anterior epistaxis (RAE) treated with either silver nitrate cauterization or microwave ablation (MWA). STUDY DESIGN and methods: In this prospective, randomized study, one hundred 13-18-year-old adolescents with RAE were assigned to two groups: the MWA group (n = 50) or the silver nitrate cauterization group (n = 50). Both groups were followed up for 12 months. The primary and secondary outcomes were evaluated. RESULT Ablation hemostasis was successfully achieved within 10-20 s in all patients in the MWA group. Eighteen (36.0%) patients in the silver nitrate group had recurrent epistaxis compared to three (6.0%) in the MWA group (P = 0.01) within 2-8 weeks after treatment. Two (2/48, 4.2%) patients in the MWA group had recurrent epistaxis compared to seventeen (17/43, 39.5%) in the silver nitrate group at 6 months; this difference was statistically significant (P = 0.01). However, 8 (8/37, 21.6%) patients in the MWA group had recurrent epistaxis compared to 15 (15/41,36.6%) in the silver nitrate group at 12 months; this difference was not statistically significant (P = 0.12). No treatment-related complications, including necrosis or septal perforation were seen in either group during follow up. CONCLUSIONS MWA may be a useful treatment for adolescents with RAE, as it had a lower incidence of recurrent epistaxis within 6 months of treatment compared to silver nitrate cauterization.
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Affiliation(s)
- Zheng-Cai Lou
- Department of Otorhinolaryngology, The Affilitaed Yiwu Hospital, Yiwu City, 322000, Zhejiang Provice, China.
| | - Fang Hong
- Department of Genetics and Metabolism, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
| | - Zi-Han Lou
- Department of Clinical Medicine, Xinxiang Medical University, Xinxiang City, 453003, Henan Provice, China
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Béquignon E, Teissier N, Gauthier A, Brugel L, De Kermadec H, Coste A, Prulière-Escabasse V. Emergency Department care of childhood epistaxis. Emerg Med J 2016; 34:543-548. [PMID: 27542804 DOI: 10.1136/emermed-2015-205528] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 07/17/2016] [Accepted: 07/24/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this review is to determine an efficient and safe primary strategy care for paediatric epistaxis. DATA SOURCES We searched PubMed and Cochrane databases for studies referenced with key words 'epistaxis AND childhood'. This search yielded 32 research articles about primary care in childhood epistaxis (from 1989 to 2015). Bibliographic references found in these articles were also examined to identify pertinent literature. We compared our results to the specific management of adult epistaxis classically described in the literature. RESULTS Epistaxis is one of the most common reasons for referral of children to a hospital ENT outpatient department. The bleeding usually originates from the anterior septum, as opposed to adults. Crusting, digital trauma, foreign bodies and nasal colonisation with Staphylococcus aureus have been suggested as specific nosebleed factors in children. Rare aetiologies as juvenile nasopharyngeal angiofibroma appear later during adolescence. There are different modes of management of mild epistaxis, which begin with clearing out blood clots and bidigital compression. An intranasal topical local anaesthetic and decongestant can be used over 6 years of age. In case of active bleeding, chemical cauterisation is preferred to anterior packing and electric cauterisation but is only feasible if the bleeding site is clearly visible. In case of non-active bleeding in children, and in those with recurrent idiopathic epistaxis, antiseptic cream is easy to apply and can avoid 'acrobatic' cauterisation liable to cause further nasal cavity trauma. CONCLUSIONS Aetiologies and treatment vary with patient age and the existence or not of active bleeding at the time of the examination. Local treatments are usually easy to perform, but physicians have to ponder their indications depending on the possible complications in order to inform parents and to know paediatric epistaxis specificities.
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Affiliation(s)
- E Béquignon
- Department of Oto-rhino-laryngology Surgery, Intercommunal Hospital, Créteil, France.,INSERM U955, Créteil, France.,Université Paris-Est, Créteil, France.,Department of Oto-rhino-laryngology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - N Teissier
- Department of Paediatric otorhinolaryngology, Robert Debré Hospital, AP-HP, Paris, France.,INSERM U1141, Paris, France
| | - A Gauthier
- Department of Oto-rhino-laryngology Surgery, Intercommunal Hospital, Créteil, France
| | - L Brugel
- Department of Oto-rhino-laryngology Surgery, Intercommunal Hospital, Créteil, France
| | - H De Kermadec
- Department of Oto-rhino-laryngology Surgery, Intercommunal Hospital, Créteil, France
| | - A Coste
- Department of Oto-rhino-laryngology Surgery, Intercommunal Hospital, Créteil, France.,INSERM U955, Créteil, France.,Université Paris-Est, Créteil, France.,Department of Oto-rhino-laryngology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - V Prulière-Escabasse
- Department of Oto-rhino-laryngology Surgery, Intercommunal Hospital, Créteil, France.,INSERM U955, Créteil, France.,Université Paris-Est, Créteil, France
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