Outcome of Silver Nitrate Cauterization in Controlling Anterior Epistaxis in Children

Abstract

Objective: To assess the outcome of silver nitrate cauterization in controlling unilateral spontaneous anterior epistaxis in children in terms of success on initial attempt and  complications like recurrence of bleeding, pain, infection, exposure of septal cartilage, septal perforation and stenosis of the nostrils.

Study Design: Cross-Sectional Descriptive

Place and Duration of Study: This study was conducted at Department of ENT, Mufti Mehmood Memorial Teaching Hospital, D.I.Khan, from October 2010 to September 2012.

Materials and Methods: All patients having ages between 6-16 years with spontaneous unilateral anterior epistaxis were included in the study. Patients with bilateral anterior epistaxis, posterior epistaxis, post-traumatic epistaxis, and epistaxis due to bleeding diathesis or neoplastic lesions were excluded. Patients were managed by silver nitrate cauterization after packing the nose with ribbon gauze soaked in 4% lidocaine and adrenaline 1:1,000 in equal amounts for 5-10 minutes. Furacin antibiotic ointment was applied to the cauterized area and was continued two times daily for two weeks. All patients were reviewed fortnightly for six weeks.

Results: Mean age of the patients was 10.43±3.23 years with 49 (65.35%) males and 26 (34.65%) females. Silver nitrate cauterization was successful on initial attempt in 69 (92%) patients. Recurrence of bleeding, infection and exposure of septal cartilage were noted in 7 (9.35%), 2 (2.65%) and 1 (1.33%) cases respectively.

Conclusions: The increased success rate and decreased post procedure morbidity associated with silver nitrate cauterization make it an effective and safe procedure for managing spontaneous unilateral anterior epistaxis in children.