Local sclerotherapy with lauromacrogol versus chemical cautery with chromic acid in treatment of idiopathic recurrent anterior epistaxis

Abstract

Introduction: Epistaxis is a very common medical problem affecting up to 60% of population at a point of their life. The classic lines of treatment of significant epistaxis include, vessel compression by packing or similar maneuvers, cauterization using various types of chemicals or heat and ligation or embolization of the bleeding vessel(s). Lauromacrogol is a relatively new compound that has been recently used as a sclerosing material in some vessel-related diseases like varicose veins and Hereditary Hemorrhagic Telengectasia. Objectives: This study compared the efficacy of local sclerotherapy with Lauromacrogol and chemical cautery with chromic acid as treatments for recurrent idiopathic anterior epistaxis in adults. Patients and Methods: Patients were grouped into 2 groups. In group A Lauromacrogol was injected in the submucosa. In group B Chromic acid was applied locally to the surface over the bleeding vessel(s). The primary outcome measure was bleeding control / recurrence during 3-months follow up. Secondary outcome measures were morbidity or complications and cost of both materials. Results: The overall epistaxis control was significantly higher in group A (Lauromacrogol group) than in group B (Chromic acid group). Less morbidity was also reported in group A. Lauromacrogol was relatively more expensive. Conclusion: Local sclerotherapy with Lauromacrogol is an effective mean for controlling recurrent idiopathic anterior epistaxis in adults. Better bleeding control with less morbidity were reported during 3-months follow up than Chromic acid cautery.