International Journal of Head and Neck Surgery

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VOLUME 2 , ISSUE 2 ( May-August, 2011 ) > List of Articles


Comparison of Blind Nasal Packing vs Endoscopic Control of Epistaxis in an Emergency Setting

Sunita Chhapola, Inita Matta, Pratima Marker

Citation Information : Chhapola S, Matta I, Marker P. Comparison of Blind Nasal Packing vs Endoscopic Control of Epistaxis in an Emergency Setting. Int J Head Neck Surg 2011; 2 (2):79-82.

DOI: 10.5005/jp-journals-10001-1056

Published Online: 01-12-2012

Copyright Statement:  Copyright © 2011; The Author(s).



To compare the precision and efficacy of endoscopic control versus nasal packing in epistaxis presenting to the emergency room.


Open labelled randomized controlled trial for comparison of precision and efficacy of emergency blind nasal packing with primary endoscopic control of epistaxis.


A total of 160 consecutive patients of epistaxis in the age group of 40 to 70 years were randomized in two groups (A and B) of 80 patients each. Group A was subjected to blind nasal packing and group B to endoscopic procedure. About 48 (30%) patients were alcoholic, 64 (40%) were hypertensive and 48 (30%) patients did not have any overt predisposing factor. Bleeding time, clotting time, prothrombin time, partial thromboplastin time and international normalized ratio (INR) were done in all patients to rule out coagulation diseases.


The nasal pack of patients in group A was removed after 48 hours. The nose was endoscopically examined on 3rd day, 7th day and then 1 month after the epistaxis. A total of 44 (55%) patients of group A had nasal mucosal abrasions (p < 0.05), two (2.5%) patients had secretory otitis media (p > 0.05) and 10 (12.5%) had synechiae formation (p > 0.05). A total of 28 (35%) patients from group A had one episode of rebleed after nasal pack removal. Group B had no complications.


Epistaxis presenting to the emergency room can be precisely and effectively controlled endoscopically. Clumsy nasal packing, complications and subsequent hospitalization costs are thereby reduced.

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  1. The seats and causes of diseases. Alabama: Gryphon Editions Ltd 19831312-5. (First published in 1761).
  2. Cardiovascular epistaxis and the nasopharyngeal plexus. Laryngoscope 1949;15:1238-47.
  3. Woodruff's nasopharyngeal plexus: How important is it in posterior epistaxis? Clinical Otolaryngology 1998;23:272-79.
  4. Drug-induced epistaxis. Journal of the Royal Society of Medicine 1990;83:162-64.
  5. Drug-induced epistaxis. Journal of the Royal Society of Medicine 1990;83:812.
  6. Do patients with epistaxis have drug-induced platelet dysfunction? Clinical Otolaryngology 1995;20:407-10.
  7. A study of the association between epistaxis and severity of hypertension. American Journal of Rhinology 1998;12:269-72.
  8. Is epistaxis evidence of end-organ damage in patients with hypertension? Laryngocope 1999;109:1111-15.
  9. Recurrent epistaxis and nasal septal deviation in young adults. Clinical Otolaryngology 1996;21:12-14.
  10. Journal of Laryngology and Otology 1996;110:261-64.
  11. Selective endoscopic electrocautery for posterior epistaxis. Laryngoscope 1988;98:1348-49.
  12. Rigid endoscopy for the control of epistaxis. Archives of Otolaryngology Head and Neck Surgery 1992;118:966-67.
  13. A new bipolar diathermy probe for the outpatient management of adult acute epistaxis. Clinical Otolaryngology 1999;24:537-41.
  14. Nasal endoscope in posterior epistaxis: A preliminary evaluation. Journal of Laryngology and Otology. 1991;105:428-31.
  15. Hot-water irrigation as a treatment of posterior epistaxis. Rhinology 1996;34:18-20.
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