Intractable Epistaxis: Looking Beyond the Usual Sites

Abstract

Intractable epistaxis is a challenge to manage and often requires multiple interventions, both medical and surgical. After anterior and posterior packing, many options exist on how to manage the patient. We performed a retrospective chart review of patients who presented to a private ear, nose, and throat practice with intractable epistaxis from January 2010 until July 2015.The clinical notes were reviewed, noting the demographic characteristics of the patients and the treatment plan that followed. In particular, we determined the site of bleeding that was documented. Of the 17 patients with intractable epistaxis identified, 5 had the site of bleeding documented and were included in the study. The documented areas that may have contributed to bleeding included the nasal olfactory region (n=3), nasal inferior meatus (n=1), and sphenoethmoid recess (n=1). After resuscitation and hematologic investigation, nasal endoscopy should be considered in patients with intractable epistaxis.