Abstract
ObjectiveWe evaluated microwave ablation (MWA) for treatment of idiopathic recurrent anterior epistaxis (RAE) in children, in terms of technical feasibility, efficacy, and safety.Study designA prospective pilot case series.SettingTertiary university hospital.MethodsChildren with idiopathic RAE were treated with endoscopic MWA and reevaluated at 1 and 4 weeks and at 6 months thereafter. The primary outcome was successful hemostasis on the day of the procedure. Secondary outcomes were the rebleeding rates after 1 and 4 weeks, and 6 months, and any complications.ResultsOf the 92 children with idiopathic RAE who met the inclusion criteria, the operation was interrupted in 7 children due to intraoperative noncooperation, and silver nitrate cautery was performed instead. All procedures were completed, and hemostasis was achieved within 10–20 s by MWA in 85 children. Two to four ablations were conducted. No recurrent epistaxis occurred and no severe MWA -related complications, such as septal perforation or synechiae formation, were observed at the 6-month follow-up.ConclusionsEndoscopic MWA is a feasible and safe technique for the treatment of idiopathic pediatric RAE in the clinical setting, especially those cases that do not respond to in-office chemical cautery.
Highlights
Idiopathic epistaxis is a common complaint seen in children in rhinology outpatient clinics
Idiopathic epistaxis originates from Kiesselbach’s plexus, which is located in the anteroinferior portion of the nasal septum; this condition is known as recurrent anterior epistaxis (RAE) [1, 2]
The study population consisted of 92 children (64 boys and 28 girls) with idiopathic RAE
Summary
Idiopathic epistaxis is a common complaint seen in children in rhinology outpatient clinics. Silver nitrate cautery is the most common method of chemical cautery for the treatment of RAE, it has mainly been used to control bleeding associated with small vessels and ulceration of the nasal mucosa [3]. Many studies have shown that MWA is safe and effective in the treatment of active hemorrhage of the liver [9,10,11] and epithelioid hemangioma [12]; its use can minimize intraoperative blood loss. MWA has been used to treat severe epistaxis in adult patients in China, and has shown high success rates with minimal side effects [13, Lou Journal of Otolaryngology - Head and Neck Surgery (2019) 48:72
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