Comparison of endoscopic-guided silver nitrate cauterization and nasal packing in the treatment of epistaxis

Abstract

Background: Epistaxis is a common disorder and often presents as an emergency. The management is challenging and various modalities of the treatment of epistaxis have been described. Nasal packing and silver nitrate chemical cautery are the commonest methods of treatment. However, there is no sufficient literature regarding the comparison of these two methods in the study area. The objective of this study is to compare endoscopic-guided silver nitrate cauterization with nasal packing in the treatment of epistaxis in our institution. Objective: To compare the endoscopic-guided silver nitrate cauterization with nasal packing in the treatment of epistaxis in our environment. Patients and Methods: This was a retrospective review of patients who presented with epistaxis at our clinic. The case notes of all patients with epistaxis who were managed with anterior packing (AP), posterior packing (PP), or endoscopic cauterization (EC) were selected. Patients with incomplete records were excluded. The information obtained included sociodemographic variables, clinical details, method of treatment, complications, and treatment outcome. The data were analyzed using SPSS version 20. Results: One hundred and twenty six patients were reviewed of which 70 (55.6%) were males and 56 (44.4%) females, within the age range of 5–80 years (mean age ± SD = 33.5 ± 17.9). The success rate of EC (93.5%) was higher compared to that of AP (68.3%) and PP (74.3%). The patients treated with EC had a statistically significant lower rate of recurrence (6.5%) compared with AP (31.1%) and PP (25.7%), respectively (P = 0.037). The mean hospital stay for patients treated with EC was significantly shorter (0.8 ± 0.6 days) compared to the group treated with AP (3.2 ± 0.9 days) and PP (6.2 ± 2.7 days), respectively (P = 0.000). Conclusion: Patients with epistaxis that underwent endoscopic-guided silver nitrate cauterization had better success rate, less complication, and shorter hospital stay than the group treated with nasal packing.