Korean J Otorhinolaryngol-Head Neck Surg.  2015 Jan;58(1):32-36. 10.3342/kjorl-hns.2015.58.1.32.

Common Bleeding Sites of Posterior Epistaxis: Nasal Endoscopic Study

• Kim JS
• Jung KT
• Lee HM
• Lee SY
• Han JH

• KMID: 2277928
• DOI: http://doi.org/10.3342/kjorl-hns.2015.58.1.32

Abstract

BACKGROUND AND OBJECTIVES
Typically, posterior epistaxis means that the bleeding point cannot be visualized with anterior rhinoscopy, and it is difficult to find a localized bleeding point. Although bleeding point identification is the key to efficient management, debate and uncertainty remain around the actual location and distribution of the bleeding sites in posterior epistaxis.
SUBJECTS AND METHOD
This study was designed to clarify bleeding points of the posterior epistaxis using nasal endoscopy. In 121 of the total 150 (80.7%) cases, we could see the posterior nasal cavity in more detail and find the bleeding point precisely.
RESULTS
The most common sites of the bleeding were the posterior portion of the inferior meatus, the posterior portion of middle meatus, and the posterior septum medial to the middle turbinate in order of frequency. A total of 113 cases, corresponding to 93.4% (113/121), showed that epistaxis could be controlled very efficiently by electrocauterization and localized small packing with the help of endoscopes. In the majority of cases, non-surgical interventions were sufficient.
CONCLUSION
Bleeding could be stopped more rapidly and with less discomfort if checking the 3 most common sites early.

Keyword

Localization; Nasal endoscopy; Posterior epistaxis

MeSH Terms

Endoscopes
Endoscopy
Epistaxis*
Hemorrhage*
Nasal Cavity
Turbinates
Uncertainty