Evaluating nasal cautery techniques in epistaxis.

Area of Science:

• Otolaryngology
• Surgical Techniques
• Nasal Anatomy

Background:

• Epistaxis (nosebleeds) commonly treated with silver nitrate or bipolar electrocautery.
• Lack of established guidelines for nasal cautery contact times and power settings.
• Variability in UK ENT consultant practices for nasal cautery was unassessed.

Purpose of the Study:

• Evaluate burn depth from silver nitrate and bipolar electrocautery on porcine septa.
• Determine optimal contact times and power settings for nasal cautery.
• Assess current UK ENT consultant practices in nasal cautery.

Main Methods:

• Porcine nasal septum samples used to test silver nitrate (75%) and bipolar electrocautery.
• Varying contact times and power levels were applied.
• UK ENT consultants surveyed regarding their cautery practices.

Main Results:

• Silver nitrate cautery under 30 seconds did not result in full-thickness burns.
• Bipolar electrocautery requires <10 W and <4 seconds contact time to avoid full-thickness burns.
• Significant variation observed in current ENT consultant nasal cautery techniques.

Conclusions:

• Findings support bilateral silver nitrate cauterization for epistaxis.
• Recommendations for bipolar electrocautery settings to minimize burn complications.
• Highlights need for standardized nasal cautery protocols.