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Comparison of two coagulation techniques for the control of pediatric recurrent anterior epistaxis with allergic
Zhengcai Lou1, Zihan Lou2, Zhengnong Chen2
1Department of Otorhinolaryngology, Wenzhou medical University Affiliated Yiwu Hospital, 699 Jiangdong Road, Yiwu City, 322000, Zhejiang provice, China.
Insights
Radiofrequency coagulation (RFC) is more effective than bipolar electrocautery (BEC) for treating pediatric recurrent anterior epistaxis and allergic rhinitis. RFC resulted in fewer complications, less pain, and reduced epistaxis recurrence.
Area of Science:
- Otolaryngology
- Pediatric Medicine
Background:
- Recurrent anterior epistaxis (RAE) and allergic rhinitis (AR) are common in children.
- Treatment options for RAE and AR include bipolar electrocautery (BEC) and radiofrequency coagulation (RFC).
Purpose of the Study:
- To compare the long-term outcomes, postoperative pain, and complications of BEC versus RFC in pediatric patients with RAE and AR.
Main Methods:
- A prospective semi-randomized study included 67 children with RAE and AR.
- Patients were assigned to either BEC or RFC treatment.
- Outcomes measured included epistaxis recurrence, epistaxis severity scores (ESSs), visual analogue scale (VAS) for AR symptoms and pain, and complications.
Main Results:
- RFC showed a significantly lower rate of epistaxis recurrence at 4 weeks and 6 months compared to BEC.
- The RFC group reported lower postoperative pain and less nasal crusting.
- Fewer complications, such as septal ulceration and perforation, were observed in the RFC group.
Conclusions:
- Both BEC and RFC are effective treatments for pediatric RAE and AR.
- RFC demonstrates superior outcomes with lower recurrence rates, reduced pain, and fewer complications compared to BEC.
- RFC may be the preferred treatment for pediatric patients with RAE and AR.
Objective:
To compare the long-term outcomes, postoperative pain, and complications of bipolar electrocautery (BEC) and radiofrequency coagulation (RFC) in the treatment of pediatric patients with recurrent anterior epistaxis (RAE) and allergic rhinitis (AR).
Materials And Methods:
Children presenting with RAE and AR were prospectively semi-randomized to receive BEC or RFC during the 2-year period. We recorded the occurrence of recurrent epistaxis as well as epistaxis severity scores (ESSs) and visual analogue scale (VAS) scores for AR-related symptoms.
Results:
In total, 67 children were included: 34 in the BEC group and 33 in the RFC group. The recurrent epistaxis rate was significantly higher in the BEC group than in the RFC group at 4 weeks (17.6 % vs. 3.0 %) and at 6 months (11.8 % vs. 0.0 %); there were no significant differences at 12 months (8.8 % vs. 0.0 %). The RFC group had lower mean ESS scores at all time points. Mean VAS scores for runny nose or itchy nose showed better improvement in the RFC group. Mean VAS scores for postoperative pain were significantly lower in the RFC group at postoperative 4 weeks, as was the occurrence of nasal crusting. During the follow-up period, septal ulceration was seen in three patients at postoperative 6 months and septal perforation was observed in two patients at 12 months in the BEC group, whereas no septal necrosis or septal perforation occurred in the RFC group.
Conclusions:
Both methods were effective for treating pediatric patients with RAE and AR. However, RFC was associated with a lower incidence of recurrent epistaxis, less crusting, lower postoperative pain, and fewer complications, implying that it may be the superior treatment.
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