Treatment

Chemical Cauterycan be performed by silver nitrate. It has an acceptable safety profile.Used for mild active bleeding or after active bleeding has

been stopped.Only one side of the septum is cauterized to reduce the

risk of septal perforation.When bilateral septal cautery is warranted, the

treatments should be separated by 4 to 6 weeks to provide time for mucosal healing.

Anterior nasal packingPacking consist of nondegradable materials, such as

gauze coated with vaseline jelly, a sponge composed of hydroxylated polyvinyl acetate that expands when wet (Merocel).

Other modern types Oxidized cellulose .Purified bovine collagen foam.Porcine gelatin.Bovine gelatin–human thrombin.

These products are generally available as powders.They conform to the three-dimensional structure of the

nasal cavity and are easy to use.

Posterior nasal packingInflatable balloons, such as Epistat & Foley catheter.Traditional posterior packs with cotton gauze introduced

through the mouth and then retracted up into the nasopharynx.

Surgical treatment

Ligation can be performed in 30 to 60 minutes with the use of modern endoscopic techniques.

Embolization of the anterior and posterior ethmoid arteries is rarely performed.

Major complication, such as stroke, facial paralysis, blindness, or nephropathy.

Home careRest quietly for the next 12 to 24 hours.Topical gels, lotions, and ointments to moisturize the

mucosa and promote healing.Avoid hot liquids for at least 24 hours after a nosebleed.Avoid picking or blowing the nose for 12 hours.Avoid exercise, straining or lifting heavy items for seven

days.If he has constipation, ask the doctor for a stool softener

to prevent straining.Avoid aspirin if possible.

Produced by:

Ahmed Ali Mohamed Abd El-

Wahab