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Comparison of Radiofrequency Coagulation and Silver Nitrate Cauterization for the Treatment of Recurrent Anterior

Zhengcai Lou1, Zihan Lou2,3,4,5, Zhengnong Chen2,3,4,5

  • 1Department of Otorhinolaryngology, Wenzhou Medical University Affiliated Yiwu Hospital, Yiwu, Zhejiang Province, China.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|November 20, 2025
PubMed

Insights

Radiofrequency coagulation (RFC) is a more effective treatment for childhood recurrent anterior epistaxis (RAE) and allergic rhinitis (AR) than silver nitrate cauterization (SNC). RFC significantly reduces nosebleeds and improves nasal symptoms in children.

Area of Science:

  • Otolaryngology
  • Pediatric Medicine
  • Allergy and Immunology

Background:

  • Childhood recurrent anterior epistaxis (RAE) frequently co-occurs with allergic rhinitis (AR), causing significant patient distress.
  • Current treatment options for RAE and AR in children remain controversial.

Purpose of the Study:

  • To compare the clinical outcomes of pediatric patients with RAE and AR treated with silver nitrate cauterization (SNC) versus radiofrequency coagulation (RFC).

Main Methods:

  • A prospective, randomized controlled study was conducted involving pediatric patients with RAE and AR.
  • Patients underwent either SNC or RFC, with outcomes measured using the Epistaxis Severity Score (ESS) and Visual Analog Scale (VAS) for AR symptoms at baseline and at 4 weeks, 3 months, and 12 months post-procedure.

Main Results:

  • The RFC group showed significantly lower rebleeding rates (2% at 4 weeks, 0% at 3 and 12 months) compared to the SNC group (18% at 4 weeks, 46% at 3 months, 58% at 12 months).
  • RFC treatment resulted in significantly lower ESS and VAS scores for nasal crusting, impact on daily life, runny nose, itchy nose, and nasal obstruction compared to SNC.
  • One case of septal perforation occurred in the RFC group (ablation mode), while no septal complications were noted in the SNC group.

Conclusions:

  • The thermocoagulation mode of RFC is a safe and effective treatment for bilateral RAE in pediatric patients, significantly improving epistaxis and associated nasal symptoms.
  • RFC offers a prolonged nosebleed-free period and reduced recurrence of epistaxis within one year compared to SNC.

Keywords:
allergic rhinitisanterior epistaxisradiofrequency coagulationsilver nitrate cauterization

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