Reviving a Lost Art: Hot-water Irrigation Treatment for Intractable Epistaxis

Abstract

ABSTRACT Introduction Epistaxis is a common presentation in ear, nose, and throat (ENT). Given its substantial healthcare burden and associated morbidity, much work has been done to ascertain optimal management. Established treatment modalities include cautery and intranasal packing. Here, we describe our experience of the long forgotten yet efficacious and cost-effective technique of hot-water irrigation in patients with epistaxis. Materials and methods Hot water is flushed briskly into the nasal cavity of an actively bleeding patient. Irrigation is continued until the water running out of the nose is clear. Results Intractable epistaxis has been successfully managed in two patients with elevated bleeding risk. Patient A presented with incidental thrombocytopenia. Patient B presented having been anticoagulated with low-molecular weight heparin (LMWH) for deep vein thrombosis (DVT). Active epistaxis ceased with hot-water irrigation, and both patients were discharged with no further readmissions. Discussion We recommend that the lost art of hot-water irrigation is an additional safe and useful tool to combat the common presentation of epistaxis. How to cite this article Yeung W, Judd O. Reviving a Lost Art: Hot-water Irrigation Treatment for Intractable Epistaxis. Clin Rhinol An Int J 2019;12(1):1–2.