Clinical Analysis of Refractory Epistaxis

Lim, Sang Kyun; Joo, Eun Jeong; Kang, Ki Seok; Wee, Sung Joon; Kang, Jung Han; Park, Jeong Mi

Abstract

BACKGROUND AND OBJECTIVES
Epistaxis is a frequently seen disease in the field of otorhinolaryngology. However, many patients have to revisit the hospital because of the failure of the initial treatment, in which cases, the inconvenience is greater due to more severe bleeding. We studied epistaxis patients who visited our service during the last 10 years to analyze the causes of visits and the possible countermeasures. SUBJECTS AND METHOD: We studied retrospectively the clinical cases of 616 emmergency patients and 65 patients admitted for the treatment of epistaxis during the last 10 years, from August 1995 to July 2004. The group I, 505 patients (74.2%), improved with only one treatment. The group II, 176 patients (25.8%), showed refractory epistaxis following the initial treatment. RESULTS: In the group I, Kisselbach's area (68.1%) was the most common site to be treated, followed by Woodruff's area (13.5%), anterior end of inferior turbinate (8.3%), and superior portion of septum (2.0%). In the group II, the most frequent area to be treated was Woodruff's area (46.0%), followed by Kisselbach's area (31.8%), superior portion of septum (4.6%), anterior end of inferior turbinate (4.0%). CONCLUSION: The most important factor in the failure of primary care was because the precise area of bleeding was not found at the time of initial treatment. Therefore, it is important that we must check the areas by endoscope carefully to decrease the failure of initial treatment of epistaxis.