Comparison of nasendoscopic-assisted cautery versus packing for the treatment of epistaxis

Epistaxis is one of the commonest ear, nose and throat presentations. We present a study of our unit's management of epistaxis, comparing 48 h of nasal packing with nasendoscopic-guided cautery.

A search was performed for the diagnosis of epistaxis, according to the (International Statistic Classification of Diseases and Related Health Problems, 10th Revision, Australia Modification) diagnosis code R04.0. Admissions from January 2007 to December 2007 were included. Patients in the first 6 months were treated with 48 h of nasal packing, that is, conventional treatment (CT). In the second half of the year, nasendoscopic cautery (NC) was performed. A retrospective chart review was then performed.

Thirty-three patients were included in the analysis with 15 (45.5%) males and 18 (54.5%) females. The median age was 77.5 years (range 21-87). The majority (50%, n= 16) of the epistaxis was idiopathic with an anterior bleed. A quarter (n= 8) were treated with NC and the rest had the CT. The average length of stay in the CT group was 1.55 days and 0.84 days in the NC group (P-value 0.049). There were no complications in the NC group compared with 44% in the CT group (P= 0.005). There was no re-presentation in the NC group.

We have shown NC for epistaxis to be an effective treatment. In our study, it was associated with a significantly reduced hospital admission, complication rate and with no re-presentations.