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epistaxis managment

B Verillaud, L Robard, J Michel, V Pruliere Escabasse, E Béquignon, L Crampette, O Malard
OBJECTIVES: The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) on second-line treatment of epistaxis in adults, after failure of anterior and/or anterior-posterior nasal packing. METHODS: A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience...
October 17, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Andrew Chang, Seckin O Ulualp, Korgun Koral, Maria Veling
OBJECTIVES: The accessory middle turbinate, a rare anatomical variation of the nasal cavity, have been systematically studied in adults. Presence of accessory middle turbinate and its clinical significance in a child has not been reported. We describe clinical appearance and radiologic features of accessory middle turbinate in a child. METHODS: Retrospective chart review. RESULTS: A 3-year-old boy presented to the otolaryngology clinic for evaluation of recurrent epistaxis...
2016: SAGE Open Med Case Rep
Brian C Dahlin, Ben Waldau
Vascular trauma is associated with blunt skull base fractures and penetrating injuries. We review the contemporary management of cranial vascular trauma, including blunt and penetrating cerebrovascular injury as well as refractory epistaxis from facial trauma.
October 2016: Journal of Neurological Surgery. Part B, Skull Base
Rajeev B Ahuja, Priya Bansal, Gaurav S Pradhan, Manju Subberwal
INTRODUCTION: Morbidity and mortality from venous thrombo-embolism (VTE) remains a significant problem for trauma and medical patients and there are established guidelines for prophylaxis in these patients. However, the efficacy and safety of VTE prophylaxis in thermally injured patients continue to be elusive as it has never been studied in a prospective, randomized fashion. Selective use of VTE prophylaxis, for high risk patients, is practiced by some burn units even if objective evidence is lacking for majority of risk factors enunciated in burn patients...
September 12, 2016: Burns: Journal of the International Society for Burn Injuries
Petros V Vlastarakos, Thomas P Nikolopoulos
BACKGROUND: Phosphodiesterase-5 (PDE-5) inhibitors enhance penile erection and have gained popularity not only for erectile dysfunction, but also in recreational settings. Nevertheless, adverse effects have been associated with their use, with nasal bleeding among them. PDE-5 inhibitor action is materialized through the inhibition of the cyclic guanosine monophosphate (cGMP) enzyme. cGMP is present at several sites of the human body in addition to the corpus cavernosum, leading to the adverse effects associated with its nonselective inhibition...
September 10, 2016: Journal of Emergency Medicine
Jong Woo Choi, Yeon Hee Joo, Woo Shik Jeong, Yong Ju Jang
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant multi-systemic disease that exhibits increasing penetrance with age. Some patients present with severe life-threatening epistaxis which is intractable to all common treatment modalities. A 63-year-old female patient with hereditary hemorrhagic telangiectasia (HHT) presented with recurrent life-threatening epistaxis that required repeated transfusions despite multiple embolizations and septodermoplasty. Previous septodermoplasty failed due to septal perforation...
September 8, 2016: Auris, Nasus, Larynx
Joo H Koh, Osama Bhatti, Abbas Mahmood, Nicholas Agar
BACKGROUND: Traumatic nasal injuries are common in all age groups of the community. Significant nasal trauma can cause nasal fractures and a range of complicating injuries. OBJECTIVE: This article provides general practitioners (GPs) with a succinct overview of pathology arising from nasal trauma, and a framework on the assessment and management of common nasal injuries. DISCUSSION: During assessment of traumatic nasal injuries, it is essential to exclude a septal haematoma, which requires urgent drainage...
September 2016: Australian Family Physician
Jashika Adil Shroff Makhasana, Meena A Kulkarni, Suhas Vaze, Adil Sarosh Shroff
Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor arising predominantly in the nasopharynx of adolescent males. It is an aggressive neoplasm and shows a propensity for destructive local spread often extending to the base of the skull and into the cranium. Clinically, however, it is obscure with painless, progressive unilateral nasal obstruction being the common presenting symptom with or without epistaxis and rhinorrhea. Diagnosis of JNA is made by complete history, clinical examination, radiography, nasal endoscopy and by using specialized imaging techniques such as arteriography, computer tomography and magnetic resonance imaging...
May 2016: Journal of Oral and Maxillofacial Pathology: JOMFP
K M Musgrave, J Powell
There is limited guidance available to clinicians regarding the management of antithrombotic therapy during epistaxis, whilst there has been an increase in the use of anticoagulation and antiplatelet therapy. In addition, the introduction of direct oral anticoagulants (DOACs), such as dabigatran and rivaroxaban, over the last decade has significantly increased the complexity of managing the anticoagulated epistaxis patient. We undertook a systemic literature review investigating potential management strategies for each class of anti-thrombotic therapy during epistaxis...
September 4, 2016: Rhinology
Duraiswamy Sankar, Radhika Krishnan, Muthusubramanian Veerabahu, Bhaskara Pandian Vikraman, J A Nathan
AIM: The aim was to determine the morbidity or mortality associated with the blind awake intubation technique in temporomandibular ankylosis patients. SETTINGS AND DESIGN: A total of 48 cases with radiographically and clinically confirmed cases of temporomandibular joint (TMJ) ankylosis were included in the study for evaluation of anesthetic management and its complications. MATERIALS AND METHODS: Airway assessment was done with standard proforma including Look externally, evaluate 3-3-2 rule, Mallampati classification, Obstruction, Neck mobility (LEMON) score assessment in all TMJ ankylosis patients...
January 2016: Annals of Maxillofacial Surgery
Sammy Sinno, Karan Mehta, Z-Hye Lee, Sarah Kidwai, Pierre B Saadeh, Michael R Lee
BACKGROUND: Inferior turbinate hypertrophy is often encountered by plastic surgeons who perform rhinoplasty. Many treatment options are available to treat the inferior turbinate. The objective of this study was to systematically review outcomes of available techniques and provide guidance to surgical turbinate management. METHODS: A MEDLINE search was performed for means of treating inferior turbinate hypertrophy. Studies selected focused on treatment of the inferior turbinate in isolation and excluding patients with refractory allergic rhinitis, vasomotor rhinitis, or hypertrophic rhinitis...
September 2016: Plastic and Reconstructive Surgery
E Béquignon, N Teissier, A Gauthier, L Brugel, H De Kermadec, A Coste, V Prulière-Escabasse
OBJECTIVE: The aim of this review is to determine an efficient and safe primary strategy care for paediatric epistaxis. DATA SOURCES: We searched PubMed and Cochrane databases for studies referenced with key words 'epistaxis AND childhood'. This search yielded 32 research articles about primary care in childhood epistaxis (from 1989 to 2015). Bibliographic references found in these articles were also examined to identify pertinent literature. We compared our results to the specific management of adult epistaxis classically described in the literature...
August 19, 2016: Emergency Medicine Journal: EMJ
Irem Iqbal, Saima Farhan, Nisar Ahmed
OBJECTIVE: To describe the clinical presentation of patients with Glanzmann's thrombasthenia (GT) and evaluate their diagnostic, clinical, and laboratory parameters including platelet aggregometry. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Hematology and Blood Transfusion, The Children Hospital and Institute of Child Health, Lahore, from January 2006 to December 2013. METHODOLOGY: Patients presenting with mucocutaneous bleeding during study period and evaluated for diagnosis of inherited platelet function disorder, were included...
August 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
M Saeed Kilani, V Lepennec, P Petit, G Magalon, D Casanova, J-M Bartoli, V Vidal
PURPOSE: The aim of this study was to report our experience in embolization of high flow peripheral arteriovenous malformations (AVMs) with Onyx. Material and methods Retrospective study of Nineteen patients (10 men, 9 women) with peripheral high-flow AVMs who were treated with arteruial embolization using Onyx were retrospectively included. AVMs were located in the head and neck (6), extremities (5), chest (2), kidney (2), uterus (2), pelvis (1) and parietal (1). In 13 patients, embolization was done using Onyx only...
August 12, 2016: Diagnostic and Interventional Imaging
Mei-Hong Zhang, A S Knisely, Neng-Li Wang, Jing-Yu Gong, Jian-She Wang
BACKGROUND: Fibrinogen storage disease (FSD) is a rare autosomal-dominant disorder caused by mutation in FGG, encoding the fibrinogen gamma chain. Here we report the first Han Chinese patient with FSD, caused by de novo fibrinogen Aguadilla mutation, and his response to pharmacologic management. CASE PRESENTATION: Epistaxis and persistent clinical-biochemistry test-result abnormalities prompted liver biopsy in a boy, with molecular study of FGG in him and his parents...
2016: BMC Gastroenterology
Paulo Saraceni Neto, Leonardo Mendes Acatauassu Nunes, Fabio de Azevedo Caparroz, Luciano Lobato Gregorio, Rafael de Paula E Silva Felice de Souza, Juliana Caminha Simões, Eduardo Macoto Kosugi
BACKGROUND: In severe cases of epistaxis, in spite of several procedures described in the literature for its management, surgical treatment has been recognized by most authors as 1 of the most effective, especially when it includes ligation and/or electrocoagulation of the nasal branches of the sphenopalatine artery. The objective of this study is to determine the importance of ethmoid crest resection during sphenopalatine artery surgery, in the management of severe epistaxis. METHODS: We report a double-blinded randomized clinical trial, in which intervention was the ethmoid crest resection during electrocoagulation of the sphenopalatine artery...
August 11, 2016: International Forum of Allergy & Rhinology
O C Wakelam, P A Dimitriadis, J Stephens
INTRODUCTION It is standard practice in the UK that if conservative measures or chemical cautery fail to control epistaxis, patients receive nasal packing which is often uncomfortable, requires admission and has well documented associated morbidity. Our study aims to evaluate the use of FloSeal haemostatic sealant in managing patients with epistaxis. MATERIALS AND METHODS Patients were identified from those referred with active epistaxis. A successful outcome was defined as complete haemostasis with FloSeal alone, with no further significant bleeding requiring admission or further interventions in the subsequent 7 days...
August 4, 2016: Annals of the Royal College of Surgeons of England
Carlos Miguel Chiesa Estomba, Iago González Fernández, Manuel Ángel Iglesias Otero
Thomas (1) stated that simply watching an expert do a procedure will not increase a student's ability to perform that procedure. In this way, training should consist of more than a slow demonstration of a procedure at the bedside by an instructor (2) . Epistaxis is a common and potentially life-threatening condition. In the emergency room, doctors admit around 81% of nasally packed patients under ENT, but only 17% have received training about managing epistaxis (3) . Moreover, the subsequent consequences that nasal pack replacement causes, including further pain and discomfort and the lack of training has implications for patient safety (3,4) ...
July 25, 2016: Clinical Otolaryngology
Daniel Raper, Dale Ding, Eric C Peterson, Richard W Crowley, Kenneth C Liu, Nohra Chalouhi, David M Hasan, Aaron S Dumont, Pascal Jabbour, Robert M Starke
INTRODUCTION: Cavernous carotid aneurysms can cause significant symptomatology through mass effect and may rupture, resulting in carotid-cavernous fistula or epistaxis. Traditional treatment options included endovascular or surgical parent vessel occlusion, or embolization; in the last decade, the development of flow-diverting stents has changed the management paradigm for these lesions. AREAS COVERED: In this review, we summarize the natural history, clinical presentation, and evolution of treatment options for cavernous carotid aneurysms and discuss developments likely to influence treatment strategies in the future...
July 22, 2016: Expert Review of Neurotherapeutics
Yoriko Yukitatsu, Kenzo Tsuzuki, Hironori Takebayashi, Masafumi Sakagami
AIM: This study reviews our clinical experience of patients with epistaxis and discusses proper management. PATIENTS AND METHODS: We retrospectively investigated 1,515 patients with epistaxis treated in our department between 2005 and 2010. RESULTS: Men over 50 years old predominated. More than half of the patients (n = 828) first visited after consultation hours, and 40% (n = 606) were brought by ambulance. The most common underlying diseases were circulatory diseases (69%, n = 1,047)...
2016: ORL; Journal for Oto-rhino-laryngology and its related Specialties
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