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Anales de Otorrinolaringología Mexicana

2019, Number 4

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Otorrinolaringología 2019; 64 (4)

Efficacy of monopolar electric vs chemical cauterization with silver nitrate in the treatment of anterior epistaxis, endoscopy and rhinoscopy assisted in outpatient adults with class I volumetric loss

López-Reynoso MT, González-Olvera SI, Prado-Calleros HM

Language: Spanish
References: 17
Page: 153-163
PDF size: 388.87 Kb.


ABSTRACT

Background: Epistaxis is one of the most common emergencies in Otolaryngology with prevalence of 60%. The chemical cauterization presents rate of failure of 54%, while the rate of success of electrical cauterization is of 89%.
Objective: To assess the efficacy of bleeding control with monopolar electrical cauterization in comparison to chemical cauterization with silver nitrate assisted by endoscopy and rhinoscopy in adult patients with anterior epistaxis.
Material and Method: A blinded controlled randomized clinical trial, including adult patients with unilateral anterior epistaxis; they were treated on an outpatient basis by the Otolaryngology service, from May to July 2018.
Results: There were included 80 patients, 41.3% (n = 33) were men. Forty-three patients were allocated for chemical cauterization with silver nitrate and 37 for monopolar electrical cauterization. Efficacy of bleeding control was achieved in 75% of the total number of patients, for the electrical cauterization group the efficacy was 94.5% vs 58.1% in chemical cauterization group (p = 0.000). Within 10 days after cauterization 18.7% of the total were re-bled, 2.7% in the electrical cauterization group vs 32.5% in chemical cauterization group (p ‹ 0.002).
Conclusions: The electrical cauterization showed greater efficacy than chemical cauterization for the control of bleeding with less frequency of rebleeding, it is a simple technique to perform, ambulatory management and with few or no complications.


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