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Updated: May 2, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
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Is nasal packing required in epistaxis?

M Sahan1, H Beydilli2, M Deveer3

  • 1Departments of Otorhinolaryngology Mugla Sitki Kocman University School of Medicine, Mugla, Turkey.

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Summary

Nasal endoscopy and cauterization effectively treat posterior epistaxis without packing. This method avoids complications associated with nasal packing, especially in elderly patients.

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Area of Science:

  • Otolaryngology
  • Rhinology

Background:

  • Posterior epistaxis presents a significant clinical challenge.
  • Traditional management often involves nasal packing, which can lead to complications.

Purpose of the Study:

  • To evaluate the efficacy of nasal endoscopy and cauterization for treating posterior epistaxis.
  • To assess the outcomes of treating posterior epistaxis without nasal packing.

Main Methods:

  • A cohort of adult patients with posterior epistaxis unsuitable for nasal packing was studied.
  • Bleeding sources were identified using nasal endoscopy.
  • Arterial sources were cauterized using bipolar or radiofrequency methods.

Main Results:

  • The study included 12 adult patients (38-72 years old) with posterior epistaxis.
  • The sphenopalatine artery was the source in 10 cases, and the anterior ethmoidal artery in 2.
  • Treatment involved bipolar cauterization (10 cases) or radiofrequency (2 cases), with successful outcomes in 3-month follow-up.

Conclusions:

  • Endoscopic identification and cauterization of the bleeding artery are highly effective for posterior epistaxis.
  • This approach avoids complications associated with nasal packing, particularly in vulnerable patient groups.
  • The Dundee epistaxis management protocol is applicable and successful in adult patients.