ENDOSCOPIC EVALUATION AND MANAGEMENT OF EPISTAXIS: AN EFFICIENT AND EFFECTIVE METHOD

Abstract

Background: Epistaxis is a common emergency condition in Otolaryngology practice. It may be either an anterior or posterior type. Proper identification of the site of bleeding is crucial. Anterior and posterior rhinoscopy examination usually fails to localize site of bleeding inside the nasal cavity. Hopkins Rod endoscope helps to visualize the site of bleeding and tailor the management of epistaxis.

Objectives: The aim of this study was to see the effectiveness of nasal endoscopy in detecting the site of epistaxis where anterior and posterior rhinoscopies failed to do so.

Materials & Methods: It was a prospective study done at Gandaki Medical College teaching hospital in patients who presented with epistaxis. Nasal examination was done with zero and 30 degree Hopkins rod endoscope and findings were noted and further treatment was planned.

Results: There were 62 patients aged 4 to 94 years with a mean age of 51.4 ±19.3 (SD) years. Patients over the age of 50 years were 48.4 %. Majority of cases (67.7%) were males and remaining were females. In 27(43.5 %) cases bleeding occurred from anterior parts of septum while 11 (17.7%) patients bled from septum posterior to spur and 7(11.2%) bled from the posterior part of the septum. 5(8.1%)patients bled from the middle part of the middle turbinate and 2 (3.2%)bleeders were seen at the sphenopalatine area. Most of the patient were treated with endoscopic diathermy.

Conclusion: Endoscope added to diagnose the exact site of bleeding and to tailor the appropriate treatment. Bipolar diathermy was the commonest mode of treatment for intractable epistaxis.

Keywords: Bipolar diathermy, Endoscopic evaluation, epistaxis