A Comparison of Bipolar Electrocautery and Chemical Cautery for Control of Pediatric Recurrent Anterior Epistaxis. (November 2015)

• Record Type: Journal Article
• Authors: Johnson, Nathan; Faria, John; Behar, Philomena
• Is Part Of: Otolaryngology--head and neck surgery. Volume 153:Number 5(2015:Nov.)
• Page Start: 851
• Page End: 856
• Publication Date: 2015-11
• Subjects: epistaxis -- sinonasal disorders -- pediatric otolaryngology; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599815589583
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To compare the outcome of children with anterior epistaxis treated intraoperatively with either bipolar electrocautery or silver nitrate chemical cautery. Study Design: Case series with chart review. Setting: Tertiary-care pediatric otolaryngology practice. Subjects: Children aged 2 to 18 years treated with either intraoperative bipolar electrocautery or silver nitrate chemical cautery of the anterior nasal septum for recurrent anterior epistaxis. Methods: Any reported bleeding event after surgery was recorded. The mean time from surgery to recurrent epistaxis was compared between groups. Results: Fifty patients underwent bipolar electrocautery, while 60 patients underwent silver nitrate chemical cautery. Within 2 years, 1 (2%) patient in the bipolar electrocautery group and 13 (22%) patients in the silver nitrate chemical cautery group had recurrent epistaxis ( P = .003). Two years after treatment, there was no difference between treatment groups. Overall, 4 patients (8%) had recurrent epistaxis postoperatively in the bipolar electrocautery group at a mean of 4.34 years after treatment, while 17 (28.3%) patients recurred after a mean of 1.53 years of treatment in the silver nitrate chemical cautery group ( P = .01). Conclusion: Compared to those treated with chemical cautery, those treated with bipolar electrocautery had a longer nosebleed-free period and a lower incidence of recurrent epistaxis within 2 years of treatment. Beyond 2 years, the treatment methods are equivocal. Bipolar electrocautery may be a superior treatment in children who will not tolerate in-office chemical cautery, in those with a risk of severe bleeding, or when it can be combined with other operative procedures.