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Suturing of Little's area of the nasal septum for epistaxis

Published online by Cambridge University Press:  20 January 2009

Z ZhengHua ,
F Gang ,
Z BingWei  and
C JiaWen
Z ZhengHua*
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University, Shanghai City, China
F Gang
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University, Shanghai City, China
Z BingWei
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University, Shanghai City, China
C JiaWen
Affiliation:
Department of Otolaryngology, Shanghai East Hospital, Tongji University, Shanghai City, China
*
Address for correspondence: Dr Zhu ZhengHua, Department of Otolaryngology, Shanghai East Hospital, Tongji University, 150 JiMo Road, Shanghai City, China200120. E-mail: brotherback@hotmail.com
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Abstract

Background:

Epistaxis is a common condition presenting to emergency and ENT clinics. Most epistaxis bleeding originates from Little's area of the nasal septum. Some cases of refractory epistaxis cannot be resolved with packing or electrocoagulation.

Method:

The suturing technique applied is widely used in surgery. When faced with pulsatile, recurrent bleeding from Little's area of the nasal septum, all rhinologists should possess the skills to be able to suture the bleeding site, especially after failure of local cautery or packing.

Case report:

The authors have successfully treated four difficult cases of nasal bleeding from Little's area by suturing.

Conclusion:

This technique could eliminate the discomfort and complications of nasal packing. To the best of our knowledge, this report probably represents the first published case series of suturing of Little's area to treat recurrent nasal bleeding. More cases need to be treated in this way to enable further evaluation of the technique.

Keywords

EpistaxisSuturesNasal Septum
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 7 , July 2009 , pp. 787 - 788
Copyright
Copyright © JLO (1984) Limited 2009

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References

1 Pallin, DJ, Chng, YM, McKay, MP, Emond, JA, Pelletier, AJ, Camargo, CA Jr. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med 2005;46:77–81CrossRefGoogle ScholarPubMed
2 Pope, LE, Hobbs, CG. Epistaxis: an update on current management. Postgrad Med J 2005;81:309–14CrossRefGoogle ScholarPubMed
3 Kucik, CJ, Clenney, T. Management of epistaxis. Am Fam Physician 2005;71:305–11Google ScholarPubMed
4 Evans, AS, Young, D, Adamson, R. Is the nasal tampon a suitable treatment for epistaxis in Accident & Emergency? A comparison of outcomes for ENT and A&E packed patients. J Laryngol Otol 2004;118:12–14CrossRefGoogle Scholar
5 Aneeshkumar, MK, Osman, E, Shahab, R, Roland, NJ. Look before you pack: key points in epistaxis management. Emerg Med J 2005;22:912–13CrossRefGoogle ScholarPubMed
6 Bray, D, Giddings, CE, Monnery, P, Eze, N, Lo, S, Toma, AG. Epistaxis: are temperature and seasonal variations true factors in incidence? J Laryngol Otol 2005;119:724–6CrossRefGoogle ScholarPubMed
7 Waddell, AN, Patel, SK, Toma, AG, Maw, AR. Intranasal steroid sprays in the treatment of rhinitis: is one better than another? J Laryngol Otol 2003;117:843–5CrossRefGoogle Scholar
8 Mei-Zahav, M, Letarte, M, Faughnan, ME, Abdalla, SA, Cymerman, U, MacLusky, IB. Symptomatic children with hereditary hemorrhagic telangiectasia: a pediatric center experience. Arch Pediatr Adolesc Med 2006;160:596–601CrossRefGoogle ScholarPubMed
9 Tan, LK, Calhoun, KH. Epistaxis. Med Clin North Am 1999;83:43–56CrossRefGoogle ScholarPubMed
10 Banerjee, AS, Kumar, BU, Sethi, N. Simple new method of protecting the septum during oxygen delivery via a nasal canula. J Laryngol Otol 2005;119:38–9CrossRefGoogle Scholar
11 Badran, K, Arya, AK. An innovative method of nasal chemical cautery in active anterior epistaxis. J Laryngol Otol 2005;119:729–30CrossRefGoogle ScholarPubMed
12 Webb, CJ, Beer, H. Posterior nasal cautery with silver nitrate. J Laryngol Otol 2004;118:713–14CrossRefGoogle ScholarPubMed
13 Pellard, S, Boyce, J, Ingrams, DR. Consent and the use of Foley catheters in epistaxis. J Laryngol Otol 2005;119:822–4CrossRefGoogle ScholarPubMed
14 Singer, AJ, Blanda, M, Cronin, K, LoGiudice-Khwaja, M, Gulla, J, Bradshaw, J et al. Comparison of nasal tampons for the treatment of epistaxis in the emergency department: a randomized controlled trial. Ann Emerg Med 2005;45:134–9CrossRefGoogle ScholarPubMed
15 Hashmi, SM, Gopaul, SR, Prinsley, PR, Sansom, JR. Swallowed nasal pack: a rare but serious complication of the management of epistaxis. J Laryngol Otol 2004;118:372–3CrossRefGoogle Scholar
16 Thomas, L, Karagama, YG, Watson, C. Avoiding alar necrosis with post-nasal packs. J Laryngol Otol 2005;119:727–8CrossRefGoogle ScholarPubMed
17 Almeida, GS, Diogenes, CA, Pinheiro, SD. Nasal endoscopy and localization of the bleeding source in epistaxis: last decade's revolution. Rev Bras Otorrinolaringol (Engl Ed) 2005;71:146–8CrossRefGoogle ScholarPubMed
18 Pothier, DD, Mackeith, S, Youngs, R. Sphenopalatine artery ligation: technical note. J Laryngol Otol 2005;119:810–12CrossRefGoogle ScholarPubMed
19 Feusi, B, Holzmann, D, Steurer, J. Posterior epistaxis: systematic review on the effectiveness of surgical therapies. Rhinology 2005;43:300–4Google ScholarPubMed
20 Umapathy, N, Quadri, A, Skinner, DW. Persistent epistaxis: what is the best practice? Rhinology 2005;43:305–8Google ScholarPubMed