Intranasal freezing for severe epistaxis.

Abstract

FOR THE PAST two years, intranasal freezing has been utilized in an effort to control severe epistaxis. Preliminary studies in dogs indicated that when experimentally produced severe epistaxis was not relieved immediately by tamponade, it was controlled rapidly by intranasal freezing. Following a freezing period of 60 minutes at −20 C, immediate biopsies revealed absence of large areas of nasal mucosa. After 24 hours, acute inflammation was present in the mucosa and submucosa accompanied by some glandular necrosis. Biopsies obtained after one week revealed partial regeneration of the mucosa. After two weeks, the histological structure appeared to be identical with prefreeze specimens. Nasal cartilage was unaffected by the freeze. 1 Twenty-one patients with severe epistaxis have had cryotherapy utilizing the intranasal balloons and the hypothermia machine. These patients were not controlled by conventional anterior and posterior packing and have been observed for at least one year after the intranasal freezing.