A study on role of nasal endoscopy for diagnosis and management of epistaxis

Epistaxis is one of the commonest ENT emergencies. It affects people of all ages, more commonly males. Bleeding may be due to local nasal pathology, systemic diseases, or sometimes no specific cause is found, which is called idiopathic epistaxis. This descriptive study was designed to evaluate role of nasal endoscopy for diagnosis and management of epistaxis in a tertiary care hospital. Sixty-two selected patients with active epistaxis or with history of epistaxis within last 24 hours were evaluated and underwent nasal endoscopy. Patients were managed following standard protocols. This study demonstrated a bimodal distribution with incidence peaks in below 20 years and above 50 years age groups. Males were affected nearly twice commonly as females. Anterior nasal bleeding was noted in majority. Most common cause was found to be hypertension closely followedby trauma. Nasal endoscopy helped to localise bleeding points in majority of the cases. Cases were managed accurately with the help of endoscopes and any local disease was eradicated thoroughly. During follow-up, endoscopy helped in early detection of recurrences and thereby prevented complications. Epistaxis can be controlled very efficiently by electro or chemical cauterisation with the help of endoscopes, the source can be localised more efficiently. In cases of failure to localise or access of bleeding points, anterior and/or posterior nasal packing can control majority of nosebleeds. In majority of cases non-surgical interventions were sufficient.