The Clinical Study and Management of Epistaxis

Abstract

Epistaxis is a very common condition that can present as a simple self-limiting to a life threatening condition. The incidence of epistaxis in general population is difficult to ascertain , at one time or the other most people experience it. It occurs more commonly in males than females. Rare in infants, children suffer much more frequently than adults. It can be unilateral or bilateral with a number of factors playing a role like age, sex, occupation, anatomical, pathological and climatic conditions etc., Epistaxis is one of the most common emergency that oto-rhinolaryngologists are asked to treat. Causes of epistaxis can be simple with self limiting to more sinister malignancy which needs a radical approach with many other condition falling in between.Objectives:1.To find out different causes of epistaxis.2.management of epistaxis regards to its etiology.Methodology: The study was conducted in the Department of ENT, Nimra Institute of Medical Sciences & Hospital during the period from January 2019 to January 2020. The prospective study included 50 patients attending the department of ENT and also patients referred from other tertiary care centers form the subjects for our study. A written informed consent taken from all patients included in the study. A detailed history taking, thorough clinical examination done for these patients. And depending upon the need of the patient, they were treated medically, anterior /posterior nasal packing and surgically, and followed for a period of 6 month. The data collected was tabulated and subjected to statistical analysis. Results: According to our study Epistaxis is more common in males of age group(20-30 years),with acute onset being more common and bilateral nose involvement being more common followed by right side, with scanty amount of epistaxis was more common (54%), followed by profuse (20%), maximum number of patient having epistaxis only for one day and 2-6% of patients had epistaxis for 5 days and above, frequency of epistaxis with more than 5 episode per day are most common.and nasal block was the most common associated symptom in our group. With hypertension(16%) being the most common associated disease and 76% not associated with any other disease, 18% patient had history of trauma in that 16% had nasal bone fracture, and 2% associated with nasal bone with maxillary bone fracture. Anterior epistaxis being the most common than posterior epistaxis , with little’s area is the most common bleeding site. 46% of the patients treated with combined modality included medical, surgical and anterior nasal packing, 26% treated with medical and anterior nasal packing , medical alone 24%, anterior and posterior nasal packing including medical treatment were 4%.and 97.9% patient had no recurrence on follow up. Conclusion: The study shows Epistaxis being more common in young adults males, trauma being the common cause followed by hypertension and idiopathic, anterior packing being most effective mode of management with minimum recurrence.