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Etiology, Management, and Outcome of Pediatric Epistaxis
Thorsten Send1, Mattis Bertlich2, Klaus Wolfgang Eichhorn1
1From the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn.
Insights
Pediatric epistaxis (nosebleeds) is common but rarely serious. Most cases resolve with simple nasal care, though underlying bleeding disorders should be considered. Silver nitrate cauterization is preferred if intervention is needed.
Area of Science:
- Otorhinolaryngology
- Pediatric Medicine
Background:
- Epistaxis is a frequent reason for pediatric medical consultation.
- Management approaches vary across disciplines.
- This review examines pediatric epistaxis from an ENT perspective.
Purpose of the Study:
- To analyze pediatric epistaxis cases treated by otorhinolaryngology.
- To identify common causes and effective treatments for childhood nosebleeds.
Main Methods:
- Retrospective chart review of patients under 18.
- Data collected from the Department of Otorhinolaryngology at the University of Bonn, Germany.
- Inclusion of 60 epistaxis episodes in 58 patients.
Main Results:
- Mean patient age was 10.1 years.
- Identified risk factors included hemorrhagic diathesis, anticoagulant medication, and prior trauma (often digital).
- 26 patients required no invasive therapy, 26 underwent cauterization, and 4 needed surgery (primarily due to noncooperation).
Conclusions:
- Childhood epistaxis is typically not severe.
- Hemorrhagic diathesis is a crucial consideration.
- Nasal mucosal care education is often sufficient; silver nitrate cauterization is recommended over electrocoagulation if intervention is required.
Objective:
Epistaxis in children is one of the most common causes for seeking professional medical help. Patients may be treated by several disciplines with various approaches to pediatric epistaxis. We reviewed cases of pediatric epistaxis from an otorhinolaryngologist's point of view.
Methods:
A retrospective chart review was performed on all patients younger than 18 years presenting with epistaxis to the Department of Otorhinolaryngology at the University of Bonn, Germany.
Results:
Sixty episodes of epistaxis in 58 patients were included in the study. Mean age was 10.1 ± 4.5 years. In terms of risk factors, 3 patients had a hemorrhagic diathesis, 3 had taken medication that interfered with hemostasis, and 8 had a history of previous trauma, most of which was digital manipulation. Twenty-six patients did not need invasive therapy. Twenty-six patients received cauterization to control the bleeding, and 4 patients needed surgery. The necessity for surgery was mainly noncooperation.
Conclusions:
Epistaxis in children is seldom serious. However, hemorrhagic diathesis needs to be kept in mind as a potential cause of epistaxis. In most cases, careful instruction of the patients and the relatives concerning nasal mucosal care is sufficient. If cauterization is necessary, silver nitrate coagulation should be preferred over electrocoagulation.
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