RESULTS OF SILVER NITRATE CAUTERIZATION IN ADULT PATIENTS WITH EPISTAXIS
Keywords:
Epistaxis, Silver-nitrate Cautery, complicationsAbstract
Objectives: To study the outcome of Silver Nitrate cauterization in patients of Epistaxis.
Material and Method: This prospective study was conducted in ENT outpatient departments of DHQ Teaching
Hospital, D.I. Khan and Khyber Teaching Hospital, Peshawar between May 2004 and June 2005. A total of 30 adult
patients, 18 males and 12 females, were in the study with the age range between 18 to 35 years. Fourteen out of
Thirty patients had recurrent epistaxis for more than three months. All bleeds were moderately severe and usually
stopped with first aid treatment. Grafco silver-nitrate applicators USA containing 37.5 mg silver-nitrate and 12.5 mg
potassium nitrate were used for cauterization after packing the nose with ribbon gauze soacked in 4% xylocaine and
Adrenaline 1:200,000 in equal amounts for 10 minutes.
Results: In 28 (93.33%) patients the active bleeder or prominent vessel was localized and cauterized with silver
nitrate applicator. Antibiotic and steroid containing cream was prescribed for two weeks. All patients were reviewed
in two, six and twelve weeks. No complication such as reaction to local anesthesia, pain at the time of cautry, septal
perforation or stenosis of nostril was recorded in the follow up period. Two cases(6.66%) had recurrence of nose
bleed in two weeks time which were mild and controlled with reapplication of silver nitrate touch.
Conclusion: Early localization of bleeding point in the nose and application of Silver nitrate is effective in preventing
recurrence of epistaxis.
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