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Factors associated with active, refractory epistaxis.

K R Jackson1, R T Jackson

  • 1Division of Otolaryngology, Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA 30322.

Archives of Otolaryngology--Head & Neck Surgery
|August 1, 1988
PubMed
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Hypertension and substance abuse significantly contribute to severe, persistent nosebleeds (epistaxis) unresponsive to initial treatment. Further investigation into clotting factors is crucial for managing intractable cases.

Area of Science:

  • Otolaryngology
  • Hematology

Background:

  • Refractory epistaxis presents a significant clinical challenge, often requiring specialized intervention.
  • Primary care management frequently fails, necessitating referral for persistent cases.

Purpose of the Study:

  • To identify underlying etiological factors contributing to severe and persistent epistaxis.
  • To evaluate the effectiveness of standard diagnostic methods in determining epistaxis causes.

Main Methods:

  • Retrospective analysis of 75 patients with treatment-failure epistaxis.
  • Clinical assessment including patient history, nasal examination, and laboratory testing.
  • Localization of bleeding source within the nasal cavity.

Main Results:

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  • Hypertension, aspirin use, and alcohol abuse were identified as major contributing factors.
  • Bleeding predominantly occurred in the posterior nasal cavity, often unrelated to structural abnormalities.
  • Standard laboratory tests were frequently insufficient for identifying the cause of intractable epistaxis.

    • Conclusions:

    • Intractable epistaxis warrants comprehensive evaluation beyond basic laboratory tests.
    • Systemic factors such as hypertension and substance abuse are critical considerations.
    • Further investigation into hemostatic abnormalities is essential for effective epistaxis management.