EVERY physician, whether in general practice or specialty, has had experiences with epistaxis. There are those cases that are cured simply by the insertion of a small piece of cotton into the anterior nare, and there are other cases that require almost uninterrupted medical attention for days or even weeks, causing many a sleepless night to physician and patient. A case of epistaxis that cannot be brought under control by repeated packings (anterior and posterior), blood transfusions, and watchful waiting is certainly a rarity. Some authors even claim that all cases of (uncomplicated) epistaxis can be controlled by this regimen. After having reviewed the literature on the subject and having considered our own experiences in this line, we believe that there are cases of epistaxis that cannot be controlled by these procedures and require such heroic measures as ligation of one or several major blood vessels. Ligation of the
WOLFERMAN A, DWYER FP. UNILATERAL AND BILATERAL LIGATION OF THE EXTERNAL CAROTID FOR EPISTAXIS. AMA Arch Otolaryngol. 1955;62(3):310–315. doi:10.1001/archotol.1955.03830030076014
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