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Published on: June 20, 2018
Surgical treatment of nasal packing refractory epistaxis
Fábio Augusto Winckler Rabelo1, Vírgilio Batista do Prado, Fabiana Cardoso Pereira Valera
1Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo.
Unlabelled:
Epistaxis is the main otorhinolaryngology emergency and, in severe cases, it can lead to hemodynamic instability and be life threatening.
Aim:
To evaluate factors involved in epistaxis resistant to nasal packing that needed surgical treatment, as well as post-surgical results.
Material And Methods:
Retrospective study from January 2002 to August 2007. 40 consecutive patients that underwent surgical treatment for refractory epistaxis were analyzed. Predisposing factors, procedures performed, need of blood transfusion, and recurrence were evaluated.
Results:
Otorhinolaryngology post operative complications (37.5%), high blood pressure (30%), and coagulopathy (15%) were the main factors related to epistaxis. 50% of the patients (n=20) presented with hemodynamic instability and 90% of them (n=18) needed blood transfusion. Eletrocauterization of the bleeding site was enough in 35% of these patients (n=14), while in 65% (n=26) was necessary cauterization and/or arterial ligation. Five patients (12.5%) had bleeding recurrence, which needed re-operation.
Conclusion:
Earlier indications of surgical treatment to control severe and refractory epistaxis to conventional treatment, especially in a population with high risk such as post operative bleeding and coagulopathies, may decrease the need of blood transfusion.
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