الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 74 |  |  |
| | | from | 74 | | |
Abstract
Epistaxis is a common problem that ranges from a minor nuisance to
a life-threatening emergency. Multiple modalities exist to treat anterior and posterior bleeding and sometimes more than one treatment must be used. Otolaryngologists must be prepared to deal with severe or refractory bleeding through the use of medications, packing materials, and radiologic or surgical interventions.
The aim of this work was to analysis etiology and different methods of interventions in management of recurrent epistaxis.
This study started with 137 patients selected to analysis etiology and different methods of interventions in management, during the period of the study from January 2016 to June 2017 at Sohag University Hospital.
The mean age of our study was 42.1 years, with a little male predominance (53%).
Regarding the side of bleeding; we found that 62% had unilateral bleeding, 83% of the cases had anterior bleeding.
Regarding the cause of epistaxis, we found that 36% of causes of epistaxis in our study had general causes; 26% had local causes; 7% had medication-related bleeding and finally 31% were idiopathic. Among the general causes of epistaxis, 35% had HTN, 12% cardiac and 17% hepatic. 47% of local causes of epistaxis represent as trauma or fracture nose and 11% as rhinitis.
Regarding management, we found that 48.88% of population show response to anterior nasal pack, 30.66% conservative treatment and 6.75% sphenopalatine artery ligation.
There was highly statistically significance between epistaxis’ management concentrated in first group regarding site of bleeding, in case of anterior bleeding population anterior nasal pack and conservative treatment was more effective, but in case of posterior bleeding population the sphenopalatine artery ligation is more common with 64.29% and finally in case of anteroposterior bleeding population the anteroposterior pack is more common with 55.56%. One patient underwent septoplasty for control of recurrent epistaxis.
Conclusion
Recurrent epistaxis in hospitalized patient is a common emergency condition in Otorhino-laryngology; affecting people of any ages. Trauma and Hypertension were the most common etiological factors among the patients in whom etiology was found although in around one third of the cases the cause may not be found. Conservative methods; especially nasal packing are effective to arrest epistaxis in most of the patients; especially if the source is anterior bleeding. Surgical intervention is needed in resistant cases, and are needed more frequently among posterior epistaxis cases.