Intranasal endoscopic minimally invasive treatment of refractory epistaxis (1)

One of the more common emergency conditions in OTOL/NASAL surgery is nosebleeds. There are many causes of nosebleeds, such as accidental trauma, nasal lesions, etc. can lead to abnormal phenomena in the nose with rich blood vessels and thin mucous membranes. And nosebleeds also have different situations, most of which are relatively simple, treatment is relatively easy, through a simple front nostril tamponice can effectively stop bleeding; but there are about 5% -10% of the nosebleeds located in the deep nasal cavity, not only poor visibility and deep parts, it is difficult to find bleeding points, conventional tamponade has a limited effect, diagnosis and treatment is more difficult, medically often classify such diseases as refractory nosebleeds.

Refractory epistaxis is characterized by repeated diseases and heavy bleeding, and it is difficult to clearly diagnose the bleeding site if the refractory epistaxis occurs by conventional examination methods. Because the nasal structure is more complex, the bleeding site is hidden, if you can not accurately judge the bleeding site, only the traditional tamponade method of treatment, compression and hemostasis is not thorough enough, then the treatment is blind; at the same time, nasal tamponade has greater damage and irritation to the nasal mucosa, and the pain of the tamponade process is also relatively large. In particular, the double nasal cavity and posterior nostril tamponade in the elderly can even lead to damage to their cardiopulmonary function, so refractory epistaxis has become one of the problems of clinical treatment.

Limited by this unfavorable condition, nasal endoscopic minimally invasive treatment of refractory nosebleeds emerged. The detection of bleeding sites under nasal endoscopy has the advantages of wide field of view and clear images, and it is easier to clearly observe the bleeding site, with the popularization of nasal endoscopic technology and the improvement of supporting technologies, nasal endoscopic minimally invasive treatment methods have been widely used clinically. Intranasal endoscopic bipolar electrocoagulation hemostasis and nasal endoscopic sphenantine artery ligation are all effective means of hemostasis.