A New Treatment for Severe Epistaxis.

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Patients with severe bleeding from the upper and posterior portions of the nasal cavity are generally treated by Bellocq tamponade, balloon tamponade or surgery, i, e, embolization or ligation of the artery. These procedures cause local pain, headache and nasal obstruction. We tried a new method of treatment in 31 patients with severe epistaxis using oxy-cellulose cotton. The bleeding was controlled adequately in 29 patients, some of whom had been treated by Bellocq tamponade in other hospitals and pleased to be free of the discomfort of their previous experiences.This new method is summarized as follows:1) It is mandatory to recognize the bleeding point, because oxy-cellulose cotton is to be packed at only one bleeding point in the nasal cavity. 2) Oxy-cellulose cotton is divided into small fragments, because the space around the bleeding point is usually narrow and deep within the nose. A piece of the divided contton is dipped in epinephrine or lidocaine solution before use because dry cotton sticks easily to normal nasal mucosa.3) Referred pain is felt in the ear when the cotton is packed on the lateral wall of the inferior meatus, and in the forehead when it is packed in the meatus olfactorius. 4) This treatment never interferes with other treatments for severe epistaxis, and combined procedures with ribbon gauze, Bellocq tamponade, balloon tamponade, etc, can be used when needed.5) Inserted cotton does not need to be removed, because it is absorbed in a few days.
耳鼻咽喉科臨床学会の論文

A New Treatment for Severe Epistaxis.

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