Endoscopic management of recurrent epistaxis: the experience of two metropolitan hospitals in Italy.

CONCLUSION

Endoscopic cauterization of the sphenopalatine artery and anterior ethmoid artery is a first-line standard of care in managing intractable epistaxis, after the failure of previous packing. Epistaxis occurs in 12% of the population. Treatment is often based on nasal packing that could be poorly effective in the treatment of severe posterior epistaxis.

OBJECTIVE

To evaluate the effectiveness of the endoscopic approach for posterior epistaxis.

METHODS

We report the experience of endoscopic cauterization in two metropolitan hospitals in Italy: 48 patients with at least one nasal packing in the 3 weeks before hospital admission. They underwent endoscopic cauterization of the sphenopalatine artery or of the anterior ethmoid artery.

RESULTS

The patients' mean age was 58.7 years; the mean hospital stay was 2.97 days. In 42 cases (87.5%), cauterization of the sphenopalatine artery was performed, and 6 (12.5%) were subjected to anterior ethmoid artery treatment. Epistaxis control was achieved in 93% of cases; 3 patients had a recurrent nasal bleeding, and were treated with anterior nasal packing. Minor complications occurred in 27.1%. We achieved a shorter hospital stay compared with patients who underwent anteroposterior packing.