Bilateral simultaneous nasal septal cauterization in children with recurrent epistaxis

To investigate the feasibility, effectiveness and complications of bilateral simultaneous silver nitrate cauterization for anterior nasal septal epistaxis in otherwise healthy children.

Prospective study in a tertiary referral otorhinolaryngology department. Thirty-seven children with anterior epistaxis between the ages of 5-16 years were included in the study. The patients who had varicose vessels or network of small vessels in the Little's area had simultaneous bilateral silver nitrate cauterization.

Complete or near-complete epistaxis control was obtained in 76% of the patients after the first cauterization, and in 86% of the patients after the second cauterization in a mean follow-up period of 8 months. Partial success was obtained in five patients. The crusting in the cauterization area was healed late in six patients. Septal perforation, tattooing, or mucocutaneous/allergic reactions were not observed in any of the patients.

Bilateral silver nitrate cauterization is an effective, feasible, low-cost and preferable treatment method in childhood epistaxis when it is applied in an appropriate concentration and at an appropriate duration in a healthy mucosal environment.