Experimental study of the possibility of topical application of polyvinylpyrrolidone for epistaxis

2021 ◽  
pp. 15-19
Author(s):  
Viktoriya Valentinovna Bykova ◽  
Svetlana Aleksandrovna Chubka
Keyword(s):  
Experimental Study ◽  
Nasal Cavity ◽  
Topical Application ◽  
Nasal Packing ◽  
Recurrent Bleeding ◽  
Mucociliary Transport ◽  
Prolonged Stay ◽  
Bleeding Vessel ◽  
Recurrent Epistaxis ◽  
Local Fibrinolysis

Nasal packing is widely used in patients with epistaxis, especially in cases where it is impossible to electrocoagulate the bleeding vessel. The disadvantages of gauze packing are well known. First of all, this is the risk of recurrent bleeding after removing the tampons from the nose. The cause of recurrent epistaxis is the activation of local fibrinolysis during prolonged stay of the tampon in the nasal cavity. To overcome this drawback, we have proposed the topical application of polyvinylpyrrolidone (PVP). In an experiment on animals, the absence of a damaging effect of PVP on mucociliary transport was proved.

scholarly journals Treatment of epistaxis without the use of nasal packing, a patient study

2011 ◽  
Vol 49 (5) ◽  
pp. 600-604
Author(s):  
Esther Vis ◽  
Herbert van den Berge
Keyword(s):  
Retrospective Study ◽  
The Netherlands ◽  
Treatment Modality ◽  
Training Programs ◽  
Cost Effective ◽  
Nasal Packing ◽  
Recurrent Bleeding ◽  
Bleeding Site ◽  
Recurrence Rates ◽  
Patient Study

We questioned how many patients with epistaxis can be treated by cautery without the use of nasal packing, as cautery is more effective and efficient. To investigate this, we performed a retrospective study of a cohort of 418 patients with epistaxis who presented to one ENT consultant at the ENT department of Medisch Centrum Leeuwarden (the Netherlands) between 1997 and 2007. Main outcomes were the treatment modality (cautery and/or nasal packing), recurrence of epistaxis and need for hospitalization. In 98% of all patients the bleeding site could be found and treated by cautery. The incidence of recurrent bleeding was 6%. Two percent of all patients had to be admitted to the hospital. This is considerably lower compared with recurrence rates and hospitalization after treatment by nasal packing known from the literature. Therefore we concluded that nearly all patients can be effectively treated by cautery with a low recurrence rate. In addition, this method of treatment is very cost effective. Because cautery requires skill and appropriate facilities, we recommend special attention for this in ENT training programs.

scholarly journals Primary mucosal malignant melanoma of the nasal cavity

2020 ◽  
Vol 6 (5) ◽  
pp. 988
Author(s):  
Subrata Mukhopadhyay ◽  
Misbahul Haque
Keyword(s):  
Computed Tomography ◽  
Malignant Melanoma ◽  
Nasal Cavity ◽  
Maxillary Antrum ◽  
Positron Emission ◽  
Recurrent Epistaxis ◽  
Mucosal Malignant Melanoma ◽  
The Right ◽  
Primary Mucosal Malignant Melanoma ◽  
Enhanced Computed Tomography

<p>Primary mucosal melanoma of the nasal cavity and paranasal sinuses is a very aggressive and rare disease with only about 0.5 % of malignant melanoma arising from the nasal cavity. There are only few reports from India. We report a rare case of sino-nasal mucosal malignant melanoma in a 58 years old female who presented with blackish coloured sino-nasal mass involving right nasal cavity, spontaneous and recurrent epistaxis and obliteration of the right naso-labial fold with occasional pain in the past 10 months. Contrast enhanced computed tomography scan showed a heterogenous mass involving right nasal cavity, right maxillary antrum and right ethmoidal area. A positron emission tomography computed tomography was also done which showed increased uptake in the region mentioned above. Initial biopsy, the mass was diagnosed as malignant melanoma. Total maxillectomy was performed with plan of post-operative radiotherapy.</p>

scholarly journals Extensive nasopharyngeal angiofibroma – case report

1970 ◽  
Vol 15 (2) ◽  
pp. 75-77
Author(s):  
M Alamgir Chowdhury ◽  
Mousumi Malakar ◽  
SM Golam Rabbani ◽  
Naseem Yasmeen ◽  
Shahidul Islam
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Nasal Cavity ◽  
Neck Region ◽  
Lateral Rhinotomy ◽  
Male Population ◽  
Vascular Neoplasm ◽  
Nasopharyngeal Angiofibroma ◽  
Recurrent Epistaxis ◽  
History Of

Juvenile nasopharyngeal angiofibroma is a benign vascular neoplasm, but it is locally aggressive. This accounts for less than 0.5% of all the neoplasm in the head & neck region in the male population only. Here we report a case of 10-year-old boy with a blackish red smooth polypoidal mass in the nasal cavity, with history of recurrent epistaxis. On physical examination it was suspected as nasopharyngeal angiofibroma. We removed it totally by lateral rhinotomy approach. And the diagnosis was nasopharyngeal angiofibroma on histopathology. Key words: Angiofibroma; Nasopharyngeal. DOI: 10.3329/bjo.v15i2.5061 Bangladesh J Otorhinolaryngol 2009; 15(2): 75-77

scholarly journals Is Routine Nasoendoscopy Warranted in Epistaxis Patients after Removal of Nasal Packing?

2011 ◽  
Vol 2 (1) ◽  
pp. ar.2011.2.0003 ◽  
Author(s):  
Tafadzwa P. Makarawo ◽  
David Howe ◽  
Samuel K. Chan
Keyword(s):  
Nasal Cavity ◽  
Final Diagnosis ◽  
Additional Benefit ◽  
Initial Presentation ◽  
Bleeding Point ◽  
Bleeding Vessel ◽  
Anterior Rhinoscopy ◽  
Additional Information ◽  
Investigative Tool ◽  
Nose And Throat

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.

scholarly journals Management Pitfalls in the use of Embolization for the Treatment of Severe Epistaxis

2002 ◽  
Vol 81 (3) ◽  
pp. 178-183 ◽  
Author(s):  
Justin M. Ortiz ◽  
Neil Bhattacharyya
Keyword(s):  
Treatment Options ◽  
Nasal Packing ◽  
Angiographic Embolization ◽  
Emergency Physicians ◽  
Traditional Treatment ◽  
Recurrent Epistaxis ◽  
Severe Epistaxis ◽  
Delays In Diagnosis ◽  
Vessel Ligation

Angiographic embolization for the treatment of severe recurrent epistaxis was added to the traditional treatment options—nasal packing, cauterization, and surgical vessel ligation—in 1974. Since then, clinical experience has shown that this procedure is safe and effective. When epistaxis cannot he controlled with cautery, nasal packing is the most common next step. As such, it is often performed by emergency physicians and other clinicians who are not otolaryngologists. We report two cases in which intranasal neoplasms were obscured as a result of a significant distortion of the normal anatomy. This distortion was secondary to emergency-room treatment of severe epistaxis by repeated nasal packing followed by angiographic embolization. Pre-embolization angiographic studies and subsequent postembolization endoscopic evaluations did not reveal the presence of the occult neoplasms because of the presence of inflammation and edema after treatment. Clinicians should be aware that nasal packing and embolization can obscure the underlying source of epistaxis, and follow-up radiologic studies and endoscopic evaluations are essential to avoid delays in diagnosis.

Local fibrinolysis and aspiration of intracerebral hematomas in rats. An experimental study using MR monitoring

1998 ◽  
Vol 20 (4) ◽  
pp. 349-352 ◽  
Author(s):  
Wolfgang Deinsberger ◽  
Marius Hartmann ◽  
Johannes Vogelt ◽  
Olav Jansen ◽  
Wolfgang Kuschinskyt ◽  
...  
Keyword(s):  
Experimental Study ◽  
Local Fibrinolysis

scholarly journals A Giant Pyogenic Granuloma of the Nasal Cavity Complicated from Nasal Packing

2001 ◽  
Vol 12 (2) ◽  
pp. 254-257
Author(s):  
Heung-Man Lee ◽  
Hee Joon Kang ◽  
Sang Hag Lee ◽  
Soon Jae Hwang
Keyword(s):  
Nasal Cavity ◽  
Pyogenic Granuloma ◽  
Nasal Packing

scholarly journals Recurrent epistaxis as manifestation of renal cell carcinoma sinonasal metastasis

2019 ◽  
Vol 147 (5-6) ◽  
pp. 364-367
Author(s):  
Miljan Folic ◽  
Aleksandar Trivic ◽  
Bojan Pavlovic ◽  
Ivan Boricic ◽  
Jovica Milovanovic
Keyword(s):  
Renal Cell Carcinoma ◽  
Nasal Cavity ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Malignant Disease ◽  
Renal Carcinoma ◽  
Radiological Examination ◽  
Anterior Cranial Fossa ◽  
Recurrent Epistaxis ◽  
Cranial Fossa

Introduction. Renal cell carcinoma is the most frequent infraclavicular primary tumor metastasizing in the sinonasal region, although these metastases are not common. We present an unusual case of recurrent epistaxis as the initial sign of renal carcinoma sinonasal metastasis and discuss the diagnostic and treatment options. Case outline. A 66-year-old patient was admitted to the hospital due to recurrent and severe epistaxis. The patient underwent nephrectomy due to renal cell carcinoma, with no signs of relapse during a three-year follow-up. Nasal endoscopy and computed tomography revealed a large mass in nasal cavity, spreading to the anterior and posterior ethmoid cells, sphenoid sinus, orbit, and anterior cranial fossa. Definite diagnosis of renal cell carcinoma metastasis in sinonasal region was made by a pathologist after biopsy and further radiological examination showed no signs of malignant disease in the abdomen, thorax, or pelvis. Although the patient had received 50 Gy of radiation therapy, the malignant disease was evaluated as progressive with further extension in anterior cranial fossa and maxilla, and the patient died five months after the occurrence of epistaxis. Conclusion. In patients with recurrent epistaxis who also had a history of renal carcinoma, endoscopic finding of tumefaction in the nasal cavity should raise a suspicion of sinonasal metastasis. In such cases, biopsy is mandatory to differentiate a metastasis from primary sinonasal tumors. Histological confirmation should be followed by radiological examination of the abdomen, thorax, and pelvis to evaluate the possibility of renal cell carcinoma recurrence or metastatic dissemination elsewhere.

scholarly journals Efficacy of Trans-nasal Endoscopic Sphenopalatine Artery Ligation in the Management of Recurrent Posterior Epistaxis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 133-137
Author(s):  
Muntasir Mahbub ◽  
Md Mahbubur Rahman
Keyword(s):  
Treatment Modalities ◽  
Recurrent Bleeding ◽  
Artery Ligation ◽  
Female Ratio ◽  
Bleeding Point ◽  
Sphenopalatine Artery ◽  
Recurrent Epistaxis ◽  
Nasal Bleeding ◽  
Endoscopic Ligation ◽  
Male To Female

Background: Recurrent posterior epistaxis is a challenging problem for most otolaryngologists. Of the several proposed treatment modalities, endoscopic ligation of SPA (Sphenopalatine artery) provides a simple and effective solution with relatively minor complications. Objectives: Aim of this study was to find out the success rate and complications of endoscopic ligation of SPA in the management of recurrent posterior epistaxis. Materials and Methods: This was an observational study conducted from Jan 2019 to Jan 2021. Total 60 patients were included in this study. Inclusion criteria were - recurrent epistaxis (at least 4 episodes in last 2 months) with bleeding point not seen in anterior rhinoscopy, Failure of previous conservative management with medications and nasal packing, age between 18–60 years of both sexes. All the patients underwent trans-nasal endoscopic Sphenopalatine artery ligation, and patients were followed up for 12 weeks to identify repeated bleeding and to evaluate complications. Results: In this study male to female ratio was 1.5:1. Mean age of study group was 44.66 (±8.62) years. No recurrent bleeding occurred in 51 (85%) and in 9 (15%) nasal bleeding occurred in the 2 months postoperative period. Anesthesia of incisor teeth occurred in 18 patients (30%), 22 patients (37%) complained about increased nasal crusting. Conclusion: Endoscopic ligation of Sphenopalatine artery shows good outcome in prevention of further episodes of epistaxis in most patients. Although some minor complications can occur, these are manageable. KYAMC Journal. 2021;12(3): 133-137

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