Effectiveness of a Nasal Saline Gel in the Treatment of Recurrent Anterior Epistaxis in Anticoagulated Patients

Abstract

We believe that the use of cauterization in patients with anterior epistaxis in the absence of acute bleeding should be discouraged because it does not address the underlying cause and because it may even worsen the condition by extending the degree of mucosal disruption. This is especially true in patients who are receiving anticoagulation therapy. Therefore, we conducted a study to determine if the use of a nasal saline gel as monotherapy would be an effective alternative to invasive measures in treating recurrent epistaxis in anticoagulated patients. Our study group consisted of 74 patients-43 men and 31 women (mean age: 64.4 yr)-who had been seen in our department over an 18-month period and whose bleeding had originated in the anterior portion of the nasal vault. Most patients had been experiencing epistaxis for at least 6 months. Patients were given the saline nasal gel and taught to gently apply it to the mucosa of the anterior nasal vault with a cotton-tipped applicator at the first sign of recurrent bleeding. Patients were then followed up periodically over the next 3 months. Among the 74 patients, 69 (93.2%) had experienced a cessation of their epistaxis at 3 months. The results of our study suggest that this simple, painless technique has considerable value as a treatment option in this cohort of patients.