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Otolaryngol Head Neck Surg. 2015 Nov;153(5):851-6. doi: 10.1177/0194599815589583. Epub 2015 Jun 30.

A Comparison of Bipolar Electrocautery and Chemical Cautery for Control of Pediatric Recurrent Anterior Epistaxis.

Author information

1
Department of Otolaryngology, University at Buffalo, Buffalo, New York, USA nathanjohnson1010@gmail.com.
2
Department of Otolaryngology, University at Buffalo, Buffalo, New York, USA.
3
Department of Otolaryngology, University at Buffalo, Buffalo, New York, USA Pediatric Ear, Nose and Throat Associates, Amherst, New York, USA.

Abstract

OBJECTIVE:

To compare the outcome of children with anterior epistaxis treated intraoperatively with either bipolar electrocautery or silver nitrate chemical cautery.

STUDY DESIGN:

Case series with chart review.

SETTING:

Tertiary-care pediatric otolaryngology practice.

SUBJECTS:

Children aged 2 to 18 years treated with either intraoperative bipolar electrocautery or silver nitrate chemical cautery of the anterior nasal septum for recurrent anterior epistaxis.

METHODS:

Any reported bleeding event after surgery was recorded. The mean time from surgery to recurrent epistaxis was compared between groups.

RESULTS:

Fifty patients underwent bipolar electrocautery, while 60 patients underwent silver nitrate chemical cautery. Within 2 years, 1 (2%) patient in the bipolar electrocautery group and 13 (22%) patients in the silver nitrate chemical cautery group had recurrent epistaxis (P = .003). Two years after treatment, there was no difference between treatment groups. Overall, 4 patients (8%) had recurrent epistaxis postoperatively in the bipolar electrocautery group at a mean of 4.34 years after treatment, while 17 (28.3%) patients recurred after a mean of 1.53 years of treatment in the silver nitrate chemical cautery group (P = .01).

CONCLUSION:

Compared to those treated with chemical cautery, those treated with bipolar electrocautery had a longer nosebleed-free period and a lower incidence of recurrent epistaxis within 2 years of treatment. Beyond 2 years, the treatment methods are equivocal. Bipolar electrocautery may be a superior treatment in children who will not tolerate in-office chemical cautery, in those with a risk of severe bleeding, or when it can be combined with other operative procedures.

KEYWORDS:

epistaxis; pediatric otolaryngology; sinonasal disorders

PMID:
26129737
DOI:
10.1177/0194599815589583
[Indexed for MEDLINE]

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