Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T01:08:16.487Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of trans-septal mattress suture of Little's area for anterior epistaxis

Published online by Cambridge University Press:  26 October 2010

S K Nitek ,
J Wysocki  and
C S Niszczota
S K Nitek*
Affiliation:
Department of Normal and Clinical Anatomy, Medical University of Warsaw, Poland
J Wysocki
Affiliation:
Otolaryngology and Rehabilitation Clinic, Medical University of Warsaw, Poland
C S Niszczota
Affiliation:
Department of Normal and Clinical Anatomy, Medical University of Warsaw, Poland
*
Address for correspondence: Dr Stanisław Nitek, Department of Normal and Clinical Anatomy, Medical University of Warsaw, 02-004 Warsaw, Chałubińskiego 5, Poland E-mail: stanislawnitek@wp.pl
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In some cases of epistaxis, anterior packing and/or electrocoagulation are not sufficient and suturing is needed. However, standard suturing techniques are sometimes ineffective. This paper reports the use of a new kind of trans-septal mattress suture, based on regional vascular anatomy, in this clinical context.

Methods:

Four adult patients with haemorrhage in Little's area underwent standard suturing, but bleeding persisted. These patients were successfully treated with trans-septal mattress suturing, using four punctures around the haemorrhage site.

Results:

No relapses or complications were observed over a six-month follow-up period.

Conclusion:

In cases of persistent bleeding from Little's area, suturing should surround the bleeding area. The described suturing method is simple, efficacious and cheap.

Keywords

EpistaxisNasal SeptumSuture
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 4 , April 2011 , pp. 399 - 401
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Pallin, DJ, Chung, 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
2Shaheen, OH. Arterial epistaxis. J Laryngol Otol 1975;89:17–34Google Scholar
3Barsan, H. Submucosal Tissucol injections in recurrent epistaxis [in French]. Schweiz Rundsch Med Prax 1990;79:944–7Google ScholarPubMed
4Beran, M, Petruson, B. Transection of varicose vessels in the nasal mucosa of patients with reccurent epistaxis. A 2-year follow-up. Clin Otolaryngol 1986;11:369–72CrossRefGoogle Scholar
5Guarisco, JL, Cheney, ML, Ohene-Frempong, K, Le Jeune, FE, Blair, PA. Limited septoplasty as treatment for recurrent epistaxis in a child with Glanzmann's thrombasthenia. Laryngoscope 1987;97:336–68CrossRefGoogle Scholar
6Juselius, H. Epistaxis. A clinical study of 1724 patients. J Laryngol Otol 1974;88:317–27Google Scholar
7Adornato, SG. A new ligation approach to the management of chronic epistaxis. Ear Nose Throat J 2000;79:721CrossRefGoogle Scholar
8Adornato, SG. Epistaxis: new approach. Otolaryngol Head Neck Surg 2000;123:524CrossRefGoogle ScholarPubMed
9Cantor, WL. Are we all stupid? Ear Nose Throat J 2001;80:117Google Scholar
10ZhengHua, Z, Gang, F, BingWei, Z, JiaWen, C. Suturing of Little's area of the nasal septum for epistaxis. J Laryngol Otol 2009;123:787–8CrossRefGoogle ScholarPubMed
11Anggard, A. Capillary and shunt blood flow in the nasal mucosa of the cat. Acta Otolaryngol 1974;78:418–22Google Scholar
12Cauna, N, Hinderer, KH. Fine structure of blood vessels of the human nasal respiratory mucosa. Ann Otol Rhinol Laryngol 1969;78:865–79CrossRefGoogle ScholarPubMed
13Standring, S, ed. Gray's Anatomy, 39th edn.Edinburg, London, New York, Oxford, Philadelphia, St Louis, Sydney, Toronto: Elsevier Churchill Livingstone, 2005;572–3Google Scholar
14Ritter, FN. The vasculature of the nose. Ann Otol Rhinol Laryngol 1970;79:468–74CrossRefGoogle ScholarPubMed