Epistaxis posterior. Revisión de una serie de 72 pacientes

  1. PICHER-GÓMEZ, Diego Juan 1
  2. NICOLÁS-MARTÍNEZ, Paula 1
  3. OSETE-ALBADALEJO, José Miguel 1
  4. DÍAZ-MANZANO, José Antonio 1
  1. 1 Universidad de Murcia
    info

    Universidad de Murcia

    Murcia, España

    ROR https://ror.org/03p3aeb86

Revista:
Revista ORL

ISSN: 2444-7986,  2444-7986

Año de publicación: 2019

Volumen: 10

Volumen: 1

Páginas: 57-64

Tipo: Artículo

DOI: 10.14201/18735 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: Revista ORL

Objetivos de desarrollo sostenible

Resumen

Nowadays there is not exhaustive consensus regarding posterior epistaxis management and different factors may vary the applied treatment. Method: 72 patients who were admitted to our center with a discharge diagnosis of posterior epistaxis between 2010 and 2015 were selected. The types of nasal packing, the invasive tratment needed, personal history associated with increase in incidence and/or mangement diffculties, age and gender were analyzed after applying the exclusion criteria. Results: The average age was 62 years old. 78% were men. 55.6% had a hypertension diagnosis, while 22.2% were diagnosed at admission. 31.9% were in oral anticoagulant therapy and 11.1% antiplatelet therapy. Bibalonated catheter was used in 60 patients (85.7%) as first nasal packing, anteroposterior nasal packing in 6 patients (8.6%). The mean time of the first tamponade was 3.74 days. 15 patients (20.8%) needed a second nasal packing and one patient needed the placement of a 3rd nasal packing. During admission, 5 patients (6.9%) required invasive treatment, in 2 of them without previous nasal packing. In 4 patients a surgical treatment was performed, and interventional treatment was performed in 2 patients. Conclusions: The bibalonated catheter is the first choice in our hospital. The nasal packing duration is lightly higher than described in the literature. After an exhaustive research about this topic, we can conclude that the therapeutic management of epistaxis is still a controversial point in Otorhinolaryngology.

Referencias bibliográficas

  • Acar B, Yavuz B, Y?ld?z E, Ozkan S, Ayturk M, Sen O et al. A possible cause of epistaxis: increased masked hypertension prevalence in patients with epistaxis. Braz J Otorhinolaryngol. 2017;83(1):45-9. - https://doi.org/10.1016/j.bjorl.2016.01.007. - PMid:27133905
  • Barnes M, Spielmann P, White P. Epistaxis: A Contemporary Evidence Based Approach. Otolaryngol Clin North Am. 2012;45(5):1005-17. - https://doi.org/10.1016/j.otc.2012.06.018. - PMid:22980681
  • Biggs T, Baruah P, Mainwaring J, Harries P, Salib R. Treatment algorithm for oral anticoagulant and antiplatelet therapy in epistaxis patients. J Laryngol Otol. 2013;127(05):483-8. - https://doi.org/10.1017/S0022215113000492. - PMid:23544790
  • Chacon J, Morales JM, Padilla M. Epistaxis y cuerpos extra-os nasales. En: Libro virtual de formación en ORL. SEORL (Madrid). http://seorl.net/libro-virtual/
  • García Callejo F, Mu-oz Fernández N, Achiques Martínez M, Frías Moya-Angeler S, Montoro Elena M, Algarra J. Taponamiento nasal en la epistaxis posterior. Comparación de dos métodos. Acta Otorrinol Esp. 2010;61(3):196-201. - https://doi.org/10.1016/j.otorri.2009.11.005. - PMid:20137770
  • Hall A, Blanchford H, Chatrath P, Hopkins C. A multi-centre audit of epistaxis management in England: is there a case for a national review of practice? J Laryngol Otol. 2015;129(05):454-7. - https://doi.org/10.1017/S0022215115000596. - PMid:25816868
  • Hall A, Simons M, Pilgrim G, Theokli C, Roberts D, Hopkins C. Epistaxis management at Guy's Hospital, 2009–2011: full audit cycles. J Laryngol Otol. 2013;128(01):82-5. - https://doi.org/10.1017/S0022215113003137. - PMid:24290872
  • Monjas-Cánovas I, Hernández-García I, Mauri-Barberá J, Sanz-Romero B, Gras-Albert J. Epidemiology of epistaxis admitted to a tertiary hospital. Acta Otorrinol Esp. 2010;61(1):41-7. - https://doi.org/10.1016/j.otorri.2009.09.003. - PMid:20004879
  • Page C, Biet A, Liabeuf S, Strunski V, Fournier A. Serious spontaneous epistaxis and hypertension in hospitalized patients. Eur Arch Otorhinolaryngol. 2011;268(12):1749-53. - https://doi.org/10.1007/s00405-011-1659-y. - PMid:21656167
  • Seno S, Arikata M, Sakurai H, Owaki S, Fukui J, Suzuki M et al. Endoscopic ligation of the sphenopalatine artery and the maxillary artery for the treatment of intractable posterior epistaxis. Am J Rhinol Allergy. 2009;23(2):197-9. - https://doi.org/10.2500/ajra.2009.23.3294. - PMid:19401049
  • Shargorodsky J, Bleier B, Holbrook E, Cohen J, Busaba N, Metson R et al. Outcomes Analysis in Epistaxis Management: Development of a Therapeutic Algorithm. Otolaryngol Head Neck Surg. 2013;149(3):390-8. - https://doi.org/10.1177/0194599813492949. - PMid:23764960
  • Sireci F, Speciale R, Sorrentino R, Turri-Zanoni M, Nicolotti M, Canevari FR. Nasal packing in sphenopalatine artery bleeding: therapeutic or harmful? Eur Arch Otorhinolaryngol. 2017;274(3):1501-5. - https://doi.org/10.1007/s00405-016-4381-y. - PMid:27837422
  • Smith J, Siddiq S, Dyer C, Rainsbury J, Kim D. Epistaxis in patients taking oral anticoagulant and antiplatelet medication: prospective cohort study. J Laryngol Otol. 2010;125(01):38-42. - https://doi.org/10.1017/S0022215110001921. - PMid:20843406
  • Soyka M, Rufibach K, Huber A, Holzmann D. Is severe epistaxis associated with acetylsalicylic acid intake? Laryngoscope. 2010;120(1):200-7.. - PMid:19877246
  • Strach K, Schröck A, Wilhelm K, Greschus S, Tschampa H, Möhlenbruch M et al. Endovascular Treatment of Epistaxis: Indications, Management, and Outcome. Cardiovasc Intervent Radiol. 2011;34(6):1190-8. - https://doi.org/10.1007/s00270-011-0155-5. - PMid:21472510
  • Supriya M, Shakeel M, Veitch D, Ah-See K. Epistaxis: prospective evaluation of bleeding site and its impact on patient outcome. J Laryngol Otol. 2010;124(07):744-9. - https://doi.org/10.1017/S0022215110000411. - PMid:20403223
  • Upile T, Jerjes W, Sipaul F, El Maaytah M, Nouraei S, Singh S et al. The role of surgical audit in improving patient management; nasal haemorrhage: an audit study. BMC Surg. 2007;7(1):19. - https://doi.org/10.1186/1471-2482-7-19. - PMid:17854499 PMCid:PMC2034528
  • Vermeeren L, Derks W, Fokkens W, Menger DJ. Complications of balloon packing in epistaxis. Eur Arch Otorhinolaryngol. 2015;272(10):3077-81. - https://doi.org/10.1007/s00405-015-3529-5. - PMid:25647471
  • Villwock J, Jones K. Recent Trends in Epistaxis Management in the United States. JAMA Otolaryngol Head Neck Surg. 2013;139(12):1279-84. - https://doi.org/10.1001/jamaoto.2013.5220. - PMid:24136624
  • von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Lancet 2007;370:1453-7. - https://doi.org/10.1016/S0140-6736(07)61602-X
  • Zarraonanadia I, Gras JR. Epistaxis. En: Llorente, Álvarez, Nú-ez, coordinadores. Manual clínico de Otorrinolaringología. Madrid: Panamericana; 2012. p.383-91.
Fuente de los datos: Dialnet