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Evaluating nasal cautery techniques in epistaxis.

J Bastianpillai¹, C Saxby¹, P Coyle²

¹Department of Ear, Nose and Throat Surgery, Northwick Park Hospital, London.

The Journal of Laryngology and Otology

|October 8, 2019

Summary

This summary is machine-generated.

Nasal cautery practices vary widely among UK ENT consultants. Optimal settings for silver nitrate and bipolar electrocautery are suggested to prevent complications like full-thickness burns during epistaxis treatment.

Keywords:

Cauterization Cautery Electrocautery Epistaxis Silver Nitrate

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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.