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How safe is submucosal diathermy?
D J Premachandra1, T R Bull, I S Mackay
1Blond McIndoe Centre for Medical Research, Queen Victoria Hospital, East Grinstead, Sussex.
The Journal of Laryngology and Otology
|May 1, 1990
Abstract:
Submucosal diathermy (SMD) is a common surgical procedure carried out to improve the nasal airway. A case is presented in which it was followed by profuse epistaxis which required transfusion of 28 units of blood, eight units of fresh frozen plasma (FFP) and four units of platelets within 14 days.
Insights
Submucosal diathermy (SMD) for nasal airway improvement can lead to severe nosebleeds (epistaxis). This case highlights a rare but serious complication requiring significant blood product transfusions.
Area of Science:
- Otolaryngology
- Surgical Complications
Background:
- Submucosal diathermy (SMD) is a widely used endoscopic surgical technique to improve nasal airflow.
- The procedure aims to reduce turbinate tissue, thereby enhancing nasal patency.
Observation:
- A patient undergoing SMD for nasal airway obstruction experienced severe, persistent epistaxis post-operatively.
- The bleeding was profuse and life-threatening, necessitating urgent medical intervention.
Findings:
- The patient required substantial blood product replacement, including 28 units of packed red blood cells, eight units of fresh frozen plasma (FFP), and four units of platelets.
- These transfusions were administered over a 14-day period to manage the ongoing hemorrhage.
Implications:
- This case underscores the potential for significant post-operative epistaxis following submucosal diathermy.
- Clinicians should be vigilant for this rare complication and prepared for aggressive management, including massive transfusion protocols.
- Further research into risk factors and preventative strategies for SMD-associated epistaxis is warranted.