Epistaxis after nasal surgery: incidence and risk factors
DOI:
https://doi.org/10.34631/sporl.725Keywords:
Epistaxis, nasal surgery, risk factorsAbstract
Objectives: To determine the incidence of epistaxis after nasal surgery as well as possible risk factors for its occurrence.
Material and methods: Retrospective study of all patients submitted to nasal surgery at the Otorhinolaryngology Department of Vila Nova de Gaia/Espinho Hospital Center during a period of 16 months.
Results: A total of 412 patients were included. The incidence of epistaxis was 4.6%. The type of surgery most frequently associated with bleeding was septoplasty (57.9%) followed by septoplasty with endoscopic sinus surgery (31.6%). The analysis of the possible risk factors concluded that the type of nasal packing presented a statistically significant association with the occurrence of epistaxis (p=0.011).
Conclusions: Epistaxis after nasal surgery is an uncommon event. Some of the classic risk factors associated with epistaxis on patients without previous history of nasal surgery may not apply to postoperative epistaxis.
References
- Cohen O, Shoffel-Havakuk H, Warman M, Tzelnick S, Haimovich Y, Kohlberg GD, Halperin D, Lahav Y. Early and Late Recurrent Epistaxis Admissions: Patterns of Incidence and Risk Factors. Otolaryngol Head Neck Surg. 2017;157(3):424-431
- Kucik CJ, Clenney T. Management of epistaxis. Am Fam. 2005;71:305.
- Sacks R, Sacks PL, Chandra R. Chapter 3: epistaxis. Am J Rhinol Allergy. 2013;27:S9-S10
- Garth RJ, Cox HJ, Thomas MR. Haemorrhage as a complication of inferior turbinectomy: a comparison of anterior and radical trimming. Clin Otolaryngol Allied Sci. 1995;20:236-238.
- May M, Levine HL, Mester SJ, Schaitkin B. Complications of endoscopic sinus surgery: analysis of 2108 patients—incidence and prevention. Laryngoscope. 1994;104:1080-1083.
- Jindal G, Gemmete J, Gandhi D. Interventional neuroradiology applications in otolaryngology, head and neck surgery. Otolaryngol Clin N Am 2012;45:1423–1449.
- Christensen NP, Smith DS, Barnwell SL, Wax MK. Arterial embolization in the management of posterior epistaxis. Otolaryngol Head Neck Surg 2005;133:748–753.
- Tomkinson A, Roblin DG, Flanagan P, Quine SM, Backhouse S. Patterns of hospital attendance with epistaxis. Rhinology. 1997;35:129-131.
- Purkey MR, Seeskin Z, Chandra R. Seasonal variation and pre-dictors of epistaxis. Laryngoscope. 2014;124:2028-2033.
- Terakura M, Fujisaki R, Suda T, Sagawa T, Sakamoto T. Relationship between blood pressure and persistent epistaxis at the emergency department: a retrospective study. J Am Soc Hypertens. 2012;6:291-295.
- Goljo E, Dang R, Iloreta AM, Govindaraj S. Cost of manage- ment in epistaxis admission: impact of patient and hospital characteristics. Laryngoscope. 2015;125:2642-2647.
- Fishpool SJ, Tomkinson A. Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK. Ann R Coll Surg Engl. 2012;94(8):559-62.