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Comparative study between different methods for treatment of recurrent anterior idiopathic epistaxis in children: a
A M Abdelghany1, A A A Hendy2, A F Allam3
1Otorhinolaryngology Department, Benha University, Benha, Egypt.
Insights
Antiseptic plus corticosteroid cream offers the most durable relief for children
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Dermatology
Background:
- Recurrent idiopathic anterior epistaxis is a common pediatric condition with debated management strategies.
- Optimal treatment for pediatric epistaxis requires evaluation of various therapeutic options.
- This study addresses the need for evidence-based guidelines in managing childhood nosebleeds.
Purpose of the Study:
- To compare the efficacy of antiseptic cream, antiseptic plus corticosteroid cream, and silver nitrate cautery.
- To evaluate the reduction in epistaxis severity using the Epistaxis Severity Score (ESS).
- To determine the most effective treatment for recurrent idiopathic anterior epistaxis in children.
Main Methods:
- A prospective randomized dual-centre clinical trial involving 136 children.
- Participants were allocated to antiseptic cream, antiseptic plus corticosteroid cream, or silver nitrate cautery.
- Epistaxis Severity Score (ESS) was measured at baseline and at 2 weeks, 1, 3, and 6 months post-intervention.
Main Results:
- All treatment groups demonstrated significant reductions in Epistaxis Severity Score (ESS) over time.
- Silver nitrate cautery provided the quickest initial improvement at 2 weeks.
- Antiseptic plus corticosteroid cream showed the most substantial and sustained improvement from 1 month to 6 months.
Conclusions:
- While silver nitrate cautery offers rapid short-term epistaxis control, antiseptic plus corticosteroid cream yields the most durable long-term improvement.
- A short, two-week course of antiseptic plus corticosteroid cream is effective.
- This combination therapy should be considered a primary treatment option for recurrent idiopathic anterior epistaxis in pediatric patients.
Introduction:
Recurrent anterior idiopathic epistaxis is common in children, yet optimal management remains debated. This study compared the efficacy of antiseptic cream, antiseptic plus corticosteroid cream, and silver nitrate cautery in reducing epistaxis severity in paediatric patients.
Methodology:
In a prospective randomised dual-centre clinical trial, 136 children with recurrent idiopathic anterior epistaxis were evenly allocated to antiseptic cream, antiseptic plus corticosteroid cream, or silver nitrate cautery. Epistaxis Severity Score was assessed at baseline, 2 weeks, and 1, 3, and 6 months.
Results:
All groups showed significant reductions in ESS over time. At 2 weeks, silver nitrate cautery produced the most rapid early improvement, compared with antiseptic cream and the combination cream. By 1 month, the antiseptic plus corticosteroid group showed the greatest improvement, with further reductions at 3 months and 6 months. At 6 months, improvement rates were highest with the combination therapy, followed by antiseptic cream and cautery.
Conclusions:
Cautery achieves rapid short-term control, but antiseptic plus corticosteroid cream provides the most durable improvement following a short, two-week course. It should be considered a first-line therapy for recurrent idiopathic anterior epistaxis in children.
