COMPARISON OF CHEMICAL CAUTERY VERSUS TOPICAL VASOCONSTRICTORS IN IDIOPATHIC PEDIATRIC ANTERIOR EPISTAXIS

Idiopathic Pediatric Anterior Epistaxis

Abstract

Objective: To compare efficacy of chemical cautery with silver nitrate along with fucidin ointment versus topical vasoconstrictor spray (xylometazoline 0.05%) and fucidin ointment application in idiopathic pediatric anterior epistaxis. Study Design: Randomized controlled trial. Place and Duration of Study: Study was carried out at Combined Military Hospital (CMH) Bahawalpur from Jan 2016 to Dec 2016.
Material and Methods: Total 112 patients fulfilling the inclusion criteria were selected from Ear Nose Throat (ENT) outpatient department at CMH Bahawalpur. They were randomly divided into two groups of 56 cases in each group. Group A individuals were treated by cauterization with 75% silver nitrate followed by fucidic acid ointment. Group-B individuals were treated with topical vasoconstrictor spray (xylometazoline 0.05% twice a day for one week) along with fucidic acid ointment. Efficacy was determined in terms of control of epistaxis, whether the procedure was effective in controlling epistaxis or otherwise i.e. patient again developed bleeding from same side of nose and needed further treatment to control epistaxis. All the cases were followed up for two months after procedure to check their efficacy.
Results: There were total 61 (54.46%) males and 51 (45.54%) females among the cases. Mean age of patients was 8.27 (± 2.34) years. Both the groups were comparable as regards the gender (p=0.817) and age (p=0.749). Group-A were treated with silver nitrate cauterization followed by fucidic acid ointmnet application and group-B were treated by vasoconstrictor nasal spray along with fucidic acid ointment. In group A (silver nitrate cautery), 87.5% cases had no rebleed during two months follow up and in group-B, 67.8% children had no rebleed during two months follow up period (p=0.022).
Conclusion: Chemical cauterization with silver nitrate along with fucidic acid ointment application was found to be more effective as compared to xylometazoline nasal spray and fucidic Acid ointment application in treating idiopathic pediatric epistaxis.