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May 1988

Selective Endoscopic Electrocautery for Posterior Epistaxis

Arch Otolaryngol Head Neck Surg. 1988;114(5):489. doi:10.1001/archotol.1988.01860170015005

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The optimal treatment of posterior epistaxis is still actively debated. At the 1988 Middle Section meeting of the Triological Society in Ann Arbor, Mich, Leonard Wurman, MD, and colleagues of Wausau, Wis, reported their experience utilizing endoscopic sinus techniques in the control of such epistaxis. In 14 of 16 patients, posterior epistaxis was controlled using the suction cautery and the 25° or 30° telescope to localize the bleeding point. Topical and regional anesthesia was most often used, with occasional patients receiving general anesthesia. Only two patients did not respond to treatment and they required internal maxillary artery ligation. Because the two-part cautery telescope is somewhat cumbersome to use, the authors are developing a combination unit. Complications were minimal, without scarring or synechiae, and the authors recommend this cost-effective method as initial management in all patients with posterior epistaxis.

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