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Comparison of microwave ablation and chemical cautery used to control adult idiopathic recurrent anterior epistaxis

Published online by Cambridge University Press:  18 February 2020

Z Lou
Z Lou*
Affiliation:
Department of Otorhinolaryngology, Yiwu Central Hospital, China
*
Author for correspondence: Dr Zhengcai Lou, Department of Otorhinolaryngology, Yiwu Central Hospital, 699 Jiangdong Road, Yiwu322000, Zhejiang, China E-mail: louzhengcai@163.com
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Abstract

Objective

This study compared the efficacy of microwave ablation and silver nitrate cautery as treatments for idiopathic recurrent anterior epistaxis in adults.

Methods

A case series with chart review was conducted. Adults with recurrent anterior epistaxis intra-operatively treated via microwave ablation or silver nitrate chemical cautery of the anterior nasal septum were enrolled. The primary outcomes were the proportion of patients in each group for whom bleeding ceased within 24 hours of treatment, and the time to successful haemostasis. The secondary outcomes were re-bleeding rates at 1 and 12 weeks and 6 months, and complications.

Results

The haemostasis success rate within 24 hours’ treatment of convex lesions was significantly higher in the microwave ablation group than in the cautery-only group. Of patients with convex lesions, the recurrence rate to six months was significantly higher in the cautery group than in the microwave ablation group, but this was not the case for those with flat lesions.

Conclusion

Microwave ablation afforded rapid and simple haemostasis for adults with recurrent anterior epistaxis in an out-patient setting. Microwave ablation had significant advantages compared to silver nitrate cautery when used to treat epistaxis in patients with convex lesions.

Keywords

MicrowavesEpistaxisNasal Septal PerforationSilver NitrateHemostasis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 3 , March 2020 , pp. 222 - 227
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Dr Z Lou takes responsibility for the integrity of the content of the paper

References

Levi, JM, McKee-Cole, KM, Barth, PC, Brody, RM, Reilly, JS. Outcomes of recalcitrant idiopathic epistaxis in children: septoplasty as a surgical treatment. Laryngoscope 2016;126:2833–7CrossRefGoogle ScholarPubMed
Mcleod, RWJ, Price, A, Williams, RJ, Smith, ME, Smith, M, Owens, D. Intranasal cautery for the management of adult epistaxis: systematic review. J Laryngol Otol 2017;131:1056–64CrossRefGoogle ScholarPubMed
Johnson, N, Faria, J, Behar, P. A comparison of bipolar electrocautery and chemical cautery for control of pediatric recurrent anterior epistaxis. Otolaryngol Head Neck Surg 2015;153:851–6CrossRefGoogle ScholarPubMed
Limbrick, J, Takwoingi, YM. Bilateral nasal septal chemical cautery: a safe and effective outpatient procedure for control of recurrent epistaxis, our experience in 134 patients. Eur Arch Otorhinolaryngol 2019;276:1845–8CrossRefGoogle ScholarPubMed
Stoddard, T, Loehrl, TA, Hunt, BC, Poetker, DM. Intractable epistaxis due to isolated primary telangiectasias. JAMA Otolaryngol Head Neck Surg 2014;140:160–3CrossRefGoogle ScholarPubMed
Iimura, J, Hatano, A, Ando, Y, Arai, C, Arai, S, Shigeta, Y et al. Study of hemostasis procedures for posterior epistaxis. Auris Nasus Larynx 2016;43:298–303CrossRefGoogle ScholarPubMed
Crossley, GH, Poole, JE, Rozner, MA, Asirvatham, SJ, Cheng, A, Chung, MK et al. The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) expert consensus statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management. Heart Rhythm 2011;8:1114–54CrossRefGoogle ScholarPubMed
O'Donnell, M, Robertson, G, McGarry, GW. A new bipolar diathermy probe for the outpatient management of adult acute epistaxis. Clin Otolaryngol Allied Sci 1999;24:537–41CrossRefGoogle ScholarPubMed
Guo, J, Tian, G, Zhao, Q, Jiang, T. Fast hemostasis: a win-win strategy for ultrasound and microwave ablation. Onco Targets Ther 2018;11:1395–402CrossRefGoogle ScholarPubMed
Sun, Y, Cheng, Z, Dong, L, Zhang, G, Wang, Y, Liang, P. Comparison of temperature curve and ablation zone between 915- and 2450-MHz cooled-shaft microwave antenna: results in ex vivo porcine livers. Eur J Radiol 2012;81:553–7CrossRefGoogle ScholarPubMed
Wai, OK, Ng, LF, Yu, PS, Chan, JC. Post-biopsy liver hemorrhage successfully controlled by ultrasound-guided percutaneous microwave ablation. J Clin Imaging Sci 2016;6:34CrossRefGoogle ScholarPubMed
Feldberg, I, Cronin, N. A 9.2 GHz microwave applicator for the treatment of menorrhagia. IEEE MTTS Int Microw Symp 1998;2:755–8Google Scholar
Lou, ZC, Hong, F, Lou, ZH. Microwave ablation versus silver nitrate cautery for treating recurrent epistaxis in adolescents: a prospective, randomized case-control study. Int J Pediatr Otorhinolaryngol 2019;121:41–5CrossRefGoogle ScholarPubMed
Lou, Z, Wei, H, Lou, Z. Identification of bleeding sites and microwave thermal ablation of posterior epistaxis. Acta Otolaryngol 2019;139:70–4CrossRefGoogle ScholarPubMed
Wright, AS, Lee, FT Jr, Mahvi, DM. Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis. Ann Surg Oncol 2003;10:275–83CrossRefGoogle ScholarPubMed
Lloyd, S, Almeyda, J, Di Cuffa, R, Shah, K. The effect of silver nitrate on nasal septal cartilage. Ear Nose Throat J 2005;84:41–4CrossRefGoogle ScholarPubMed
Hanif, J, Tasca, RA, Frosh, A, Ghufoor, K, Stirling, R. Silver nitrate: histological effects of cautery on epithelial surfaces with varying contact times. Clin Otolaryngol Allied Sci 2003;28:368–70CrossRefGoogle ScholarPubMed
Amin, M, Glynn, F, Phelan, S, Sheahan, P, Crotty, P, McShane, D. Silver nitrate cauterisation, does concentration matter? Clin Otolaryngol 2007;32:197–9Google ScholarPubMed