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Is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing?

Fiberoptic nasoendoscopy (FNE) is a powerful investigative tool in ear, nose, and throat practice in which its use in the management of epistaxis is varied among clinicians. The practice of assessing the nasal cavity after removal of nasal packs is common but its usefulness has not been evaluated. T...

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Autores principales: Makarawo, Tafadzwa P., Howe, David, Chan, Samuel K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: OceanSide Publications, Inc. 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390123/
https://www.ncbi.nlm.nih.gov/pubmed/22852109
http://dx.doi.org/10.2500/ar.2011.2.0003
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author Makarawo, Tafadzwa P.
Howe, David
Chan, Samuel K.
author_facet Makarawo, Tafadzwa P.
Howe, David
Chan, Samuel K.
author_sort Makarawo, Tafadzwa P.
collection PubMed
description Fiberoptic nasoendoscopy (FNE) is a powerful investigative tool in ear, nose, and throat practice in which its use in the management of epistaxis is varied among clinicians. The practice of assessing the nasal cavity after removal of nasal packs is common but its usefulness has not been evaluated. Therefore, we assessed the benefits of routine FNE after removal of nasal packs in epistaxis patients. Our study was performed retrospectively involving 62 adult patients admitted over a 6-month period between 2005 and 2006. Data regarding the emergent management of epistaxis cases on presentation, the use of FNE, and the final diagnosis and outcome of each patient were specifically investigated during the study. Anterior rhinoscopy was performed in 27 patients at initial presentation, of whom 45% (10/27) had anterior bleeding points identified. FNE examination after removal of nasal packs in eight patients yielded evidence of a posterior bleeding point in only one case (12.5%). Of those patients in whom anterior rhinoscopy revealed no anterior bleeding point at presentation (17/27), 12 patients went on to have FNE after removal of their nasal packs, and of these, 33% (4/12) of patients were found to have a posterior bleeding vessel. Overall, FNE was performed in 24 patients, of whom only 1 (1/24) had an active posterior bleeding vessel needing nasal repacking. Four patients (4/24) had prominent posterior vessels that required no intervention, 1 patient (1/24) had new pathology identified, and in the remaining 18 cases (18/24), FNE yielded no additional information to modify management. The routine performance of FNE in all epistaxis patients after pack removal does not appear to convey any additional benefit. We advocate the use of FNE when anterior bleeding has been excluded or bleeding is persistent and that careful nasal examination by anterior rhinoscopy should be the cornerstone of assessment.
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spelling pubmed-33901232012-07-31 Is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing? Makarawo, Tafadzwa P. Howe, David Chan, Samuel K. Allergy Rhinol (Providence) Articles Fiberoptic nasoendoscopy (FNE) is a powerful investigative tool in ear, nose, and throat practice in which its use in the management of epistaxis is varied among clinicians. The practice of assessing the nasal cavity after removal of nasal packs is common but its usefulness has not been evaluated. Therefore, we assessed the benefits of routine FNE after removal of nasal packs in epistaxis patients. Our study was performed retrospectively involving 62 adult patients admitted over a 6-month period between 2005 and 2006. Data regarding the emergent management of epistaxis cases on presentation, the use of FNE, and the final diagnosis and outcome of each patient were specifically investigated during the study. Anterior rhinoscopy was performed in 27 patients at initial presentation, of whom 45% (10/27) had anterior bleeding points identified. FNE examination after removal of nasal packs in eight patients yielded evidence of a posterior bleeding point in only one case (12.5%). Of those patients in whom anterior rhinoscopy revealed no anterior bleeding point at presentation (17/27), 12 patients went on to have FNE after removal of their nasal packs, and of these, 33% (4/12) of patients were found to have a posterior bleeding vessel. Overall, FNE was performed in 24 patients, of whom only 1 (1/24) had an active posterior bleeding vessel needing nasal repacking. Four patients (4/24) had prominent posterior vessels that required no intervention, 1 patient (1/24) had new pathology identified, and in the remaining 18 cases (18/24), FNE yielded no additional information to modify management. The routine performance of FNE in all epistaxis patients after pack removal does not appear to convey any additional benefit. We advocate the use of FNE when anterior bleeding has been excluded or bleeding is persistent and that careful nasal examination by anterior rhinoscopy should be the cornerstone of assessment. OceanSide Publications, Inc. 2011 /pmc/articles/PMC3390123/ /pubmed/22852109 http://dx.doi.org/10.2500/ar.2011.2.0003 Text en Copyright © 2011, OceanSide Publications, Inc., U.S.A. This publication is provided under the terms of the Creative Commons Public License ("CCPL" or "License"), in attribution 3.0 unported (Attribution Non-Commercial No Derivatives (CC BY-NC-ND)), further described at: http://creativecommons.org/license/by-nc-nd/3.0/legalcode. The work is protected by copyright and/or other applicable law. Any use of the work other then as authorized under this license or copyright law is prohibited.
spellingShingle Articles
Makarawo, Tafadzwa P.
Howe, David
Chan, Samuel K.
Is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing?
title Is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing?
title_full Is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing?
title_fullStr Is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing?
title_full_unstemmed Is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing?
title_short Is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing?
title_sort is routine nasoendoscopy warranted in epistaxis patients after removal of nasal packing?
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390123/
https://www.ncbi.nlm.nih.gov/pubmed/22852109
http://dx.doi.org/10.2500/ar.2011.2.0003
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