Outcome of Silver Nitrate Cauterization in Adults with Anterior Epistaxis at a Tertiary Care Hospital in Peshawar, Khyber Pakhtunkhwa

Abstract

Introduction: Epistaxis is a common emergency presentation (7-14% population annually) which may pose difficulties in management. Although only 6% require formal medical intervention but they can be serious and even life threatening.

Objective: To document the outcome and efficacy of silver nitrate cauterization in patients with anterior epistaxis presenting to a tertiary care hospital of Peshawar, KP.

Materials & Methods: Fifty patients presenting with spontaneous anterior epistaxis of moderate degree were included in this study conducted on Outpatient basis from March 01, 2017 to September 30, 2017 in the department of Otorhinolaryngology-A unit of Hayatabad Medical Complex, Peshawar, based on prospective data collection and convenience sampling. Cases were managed with silver nitrate cautery and followed for ten weeks to document recurrent epistaxis. Data were analyzed manually for descriptive statistics.

Results: Fourteen (28%) patients were females and 36(72%) were males with age ranging from 18-40 years. Thirty-two (64%) patients had a prominent bleeder. In 8(16%) patients the bleeder was seen after local packing with xylocaine solution. In 8(16%) patients the bleeder was difficult to localize and was identified by repeated local packs of xylocaine mixed with adrenaline. Five patients (10%) had recurrent epistaxis within the first week after discharge, and cautery was repeated again with no further recurrence.

Conclusion: Silver nitrate cauterization was effective in controlling spontaneous anterior epistaxis of moderate severity.