Microwave ablation versus silver nitrate cautery for treating recurrent epistaxis in adolescents: A prospective, randomized case-control study

Abstract

ObjectiveTo compare the outcomes of adolescent patients with recurrent anterior epistaxis (RAE) treated with either silver nitrate cauterization or microwave ablation (MWA). Study designand methods: In this prospective, randomized study, one hundred 13–18-year-old adolescents with RAE were assigned to two groups: the MWA group (n = 50) or the silver nitrate cauterization group (n = 50). Both groups were followed up for 12 months. The primary and secondary outcomes were evaluated. ResultAblation hemostasis was successfully achieved within 10–20 s in all patients in the MWA group. Eighteen (36.0%) patients in the silver nitrate group had recurrent epistaxis compared to three (6.0%) in the MWA group (P = 0.01) within 2–8 weeks after treatment. Two (2/48, 4.2%) patients in the MWA group had recurrent epistaxis compared to seventeen (17/43, 39.5%) in the silver nitrate group at 6 months; this difference was statistically significant (P = 0.01). However, 8 (8/37, 21.6%) patients in the MWA group had recurrent epistaxis compared to 15 (15/41,36.6%) in the silver nitrate group at 12 months; this difference was not statistically significant (P = 0.12). No treatment-related complications, including necrosis or septal perforation were seen in either group during follow up. ConclusionsMWA may be a useful treatment for adolescents with RAE, as it had a lower incidence of recurrent epistaxis within 6 months of treatment compared to silver nitrate cauterization.