Hemostasis of idiopathic recurrent epistaxis in children with microwave ablation: a prospective pilot case series

OBJECTIVE: We evaluated microwave ablation (MWA) for treatment of idiopathic recurrent anterior epistaxis (RAE) in children, in terms of technical feasibility, efficacy, and safety. STUDY DESIGN: A prospective pilot case series. SETTING: Tertiary university hospital. METHODS: Children with idiopathic RAE were treated with endoscopic MWA and reevaluated at 1 and 4 weeks and at 6 months thereafter. The primary outcome was successful hemostasis on the day of the procedure. Secondary outcomes were the rebleeding rates after 1 and 4 weeks, and 6 months, and any complications. RESULTS: Of the 92 children with idiopathic RAE who met the inclusion criteria, the operation was interrupted in 7 children due to intraoperative noncooperation, and silver nitrate cautery was performed instead. All procedures were completed, and hemostasis was achieved within 10–20 s by MWA in 85 children. Two to four ablations were conducted. No recurrent epistaxis occurred and no severe MWA -related complications, such as septal perforation or synechiae formation, were observed at the 6-month follow-up. CONCLUSIONS: Endoscopic MWA is a feasible and safe technique for the treatment of idiopathic pediatric RAE in the clinical setting, especially those cases that do not respond to in-office chemical cautery.