Etiology, Management, and Outcome of Pediatric Epistaxis.
Journal
Pediatric emergency care
ISSN: 1535-1815
Titre abrégé: Pediatr Emerg Care
Pays: United States
ID NLM: 8507560
Informations de publication
Date de publication:
01 Sep 2021
01 Sep 2021
Historique:
pubmed:
10
1
2019
medline:
3
9
2021
entrez:
10
1
2019
Statut:
ppublish
Résumé
Epistaxis in children is one of the most common causes for seeking professional medical help. Patients may be treated by several disciplines with various approaches to pediatric epistaxis. We reviewed cases of pediatric epistaxis from an otorhinolaryngologist's point of view. A retrospective chart review was performed on all patients younger than 18 years presenting with epistaxis to the Department of Otorhinolaryngology at the University of Bonn, Germany. Sixty episodes of epistaxis in 58 patients were included in the study. Mean age was 10.1 ± 4.5 years. In terms of risk factors, 3 patients had a hemorrhagic diathesis, 3 had taken medication that interfered with hemostasis, and 8 had a history of previous trauma, most of which was digital manipulation. Twenty-six patients did not need invasive therapy. Twenty-six patients received cauterization to control the bleeding, and 4 patients needed surgery. The necessity for surgery was mainly noncooperation. Epistaxis in children is seldom serious. However, hemorrhagic diathesis needs to be kept in mind as a potential cause of epistaxis. In most cases, careful instruction of the patients and the relatives concerning nasal mucosal care is sufficient. If cauterization is necessary, silver nitrate coagulation should be preferred over electrocoagulation.
Identifiants
pubmed: 30624421
pii: 00006565-202109000-00007
doi: 10.1097/PEC.0000000000001698
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
466-470Informations de copyright
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: The authors declare no conflict of interest.
Références
McIntosh N, Mok JY, Margerison A. Epidemiology of oronasal hemorrhage in the first 2 years of life: implications for child protection. Pediatrics . 2007;120:1074–1078.
Hey E. Sudden oronasal bleeding in a young child. Acta Paediatr . 2008;97:1327–1330.
Kime C, Klima J, Rose MJ, et al. Patterns of inpatient care for newly diagnosed immune thrombocytopenia in US children's hospitals. Pediatrics . 2013;131:880–885.
Blount A, Riley KO, Woodworth BA. Juvenile nasopharyngeal angiofibroma. Otolaryngol Clin North Am . 2011;44:989–1004. ix.
Pallin DJ, Chng Y-M, McKay MP, et al. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med . 2005;46:77–81.
Davies K, Batra K, Mehanna R, et al. Pediatric epistaxis: epidemiology, management & impact on quality of life. Int J Pediatr Otorhinolaryngol . 2014;78:1294–1297.
Petruson B. Epistaxis in childhood. Rhinology . 1979;17:83–90.
Siddiq S, Grainger J. Fifteen-minute consultation: investigation and management of childhood epistaxis. Arch Dis Child Educ Pract Ed . 2015;100:2–5.
van Bremen T, Glien A, Graff I, et al. Interdisciplinary emergency departments: first experiences from the ENT and head and neck perspective. HNO . 2012;60:1060–1066.
Sauter TC, Hegazy K, Hautz WE, et al. Epistaxis in anticoagulated patients: fewer hospital admissions and shorter hospital stays on rivaroxaban compared to phenprocoumon. Clin Otolaryngol . 2018;43:103–108.
Send T, Bertlich M, Horlbeck F, et al. Management and outcome of epistaxis under direct oral anticoagulants: a comparison with warfarin. Int Forum Allergy Rhinol . 2018.
Joice P, Ross P, Robertson G, et al. The effect of hand dominance on recurrent idiopathic paediatric epistaxis. Clin Otolaryngol . 2008;33:570–574.
Kamble P, Saxena S, Kumar S. Nasal bacterial colonization in cases of idiopathic epistaxis in children. Int J Pediatr Otorhinolaryngol . 2015;79:1901–1904.
Whymark AD, Crampsey DP, Fraser L, et al. Childhood epistaxis and nasal colonization with Staphylococcus aureus . Otolaryngol Head Neck Surg . 2008;138:307–310.
Montague M-L, Whymark A, Howatson A, et al. The pathology of visible blood vessels on the nasal septum in children with epistaxis. Int J Pediatr Otorhinolaryngol . 2011;75:1032–1034.
Gifford TO, Orlandi RR. Epistaxis. Otolaryngol Clin North Am . 2008;41:525–536. viii.
Kubba H, MacAndie C, Botma M, et al. A prospective, single-blind, randomized controlled trial of antiseptic cream for recurrent epistaxis in childhood. Clin Otolaryngol Allied Sci . 2001;26:465–468.
Sadick H, Fleischer I, Goessler U, et al. Twenty-four-hour and annual variation in onset of epistaxis in Osler disease. Chronobiol Int . 2007;24:357–364.
Boscardini L, Zanetta S, Ballardini G, et al. Epistaxis in children under the age of two: possible marker of abuse/neglect? A retrospective study in North-Eastern Piedmont hospitals. Minerva Pediatr . 2013;65:71–75.
DeLaroche AM, Tigchelaar H, Kannikeswaran N. A rare but important entity: epistaxis in infants. J Emerg Med . 2017;52:89–92.
Zagolski O, Dwivedi RC, Subramanian S, et al. Non–Hodgkin's lymphoma of the sino-nasal tract in children. J Cancer Res Ther . 2010;6:5–10.
Purkey MR, Seeskin Z, Chandra R. Seasonal variation and predictors of epistaxis. Laryngoscope . 2014;124:2028–2033.
Patel N, Maddalozzo J, Billings KR. An update on management of pediatric epistaxis. Int J Pediatr Otorhinolaryngol . 2014;78:1400–1404.
Sandoval C, Dong S, Visintainer P, et al. Clinical and laboratory features of 178 children with recurrent epistaxis. J Pediatr Hematol Oncol . 2002;24:47–49.
Cruz NS, Alvarez RG. Rattlesnake bite complications in 19 children. Pediatr Emerg Care . 1994;10:30–33.
El Boussaadni Y, Babakhouya A, Amrani R, et al. Leeches: an unusual cause of epistaxis in children. Presse Med . 2017;46:545–547.
Calder N, Kang S, Fraser L, et al. A double-blind randomized controlled trial of management of recurrent nosebleeds in children. Otolaryngol Head Neck Surg . 2009;140:670–674.
Glynn F, Amin M, Sheahan P, et al. Prospective double blind randomized clinical trial comparing 75% versus 95% silver nitrate cauterization in the management of idiopathic childhood epistaxis. Int J Pediatr Otorhinolaryngol . 2011;75:81–84.
Baugh TP, Chang CWD. Epidemiology and management of pediatric epistaxis. Otolaryngol Head Neck Surg . 2018;159:712–716.
Spangler D, Rothenburger S, Nguyen K, et al. In vitro antimicrobial activity of oxidized regenerated cellulose against antibiotic-resistant microorganisms. Surg Infect (Larchmt) . 2003;4:255–262.
de Bonnecaze G, Gallois Y, Chaynes P, et al. Intractable epistaxis: which arteries are responsible? An angiographic study. Surg Radiol Anat . 2017;39:1203–1207.
Villwock JA, Jones K. Recent trends in epistaxis management in the United States: 2008–2010. JAMA Otolaryngol Head Neck Surg . 2013;139:1279–1284.