Long Term Outcomes of Paediatric Epistaxis Management-Follow-Up From a 4-Year Prospective Cohort Study

Recurrent paediatric epistaxis is a common condition that is often distressing for children and their caregivers. Although treatments such as Naseptin or silver nitrate cautery are widely used, a recurrence of epistaxis after an initial symptom-free period is frequent. Yet, there is a lack of robust, long-term studies comparing treatment modalities and sustained success rates. This study aims to address that gap by evaluating long-term outcomes in a previously established paediatric cohort.

We performed a follow-up analysis of a 2020 cohort at a tertiary paediatric otolaryngology centre. Patients were contacted by letter and SMS to schedule a telephone appointment. Anonymised data, including age, sex, healthcare attendances, interventions and epistaxis frequency, were collected using a standardised proforma. Statistical analysis was performed using R Statistical Software (v4.5.1; R Core Team 2025).

Two hundred and ten patients were scheduled for a telephone appointment and 145 (69.0%) were successfully contacted. Mean age was 13.08 years, with 125 males and 85 females. Median follow-up was 48 months. Among the 75 patients (51.7%) who reported persistent epistaxis, 65.3% (n = 49) had not sought any further medical care. Persistent epistaxis was reported in 44.1% (n = 30) of patients treated with Naseptin alone, compared to 57.6% (n = 30) of those who also received silver nitrate cautery. There was no significant difference in the rate of recurrence between Naseptin and added cautery.

Persistent epistaxis was common, with no significant difference between treatment with Naseptin alone and those who also received silver nitrate cautery. Patient/parent education is essential to explain the aetiology of recurrent paediatric epistaxis, its natural history and appropriate first aid.