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ENDOSCOPIC MANAGEMENT OF EPISTAXIS: CLINICAL EFFICACY AND
OUTCOMES
¹Muxtorov Anvar Kamol oʻgʻli
²Yusubov Shohzod Otabek oʻgʻli
³Rahmonov Muhammad Ibrohimovich
¹'²'³Samarkand State Medical University, Department of Otorhinolaryngology No. 2, 1st Year
Clinical Residents.
https://doi.org/10.5281/zenodo.15511416
Research Objective
The main objective of this research was to evaluate the clinical efficacy of endoscopic
approaches in the management of both anterior and posterior epistaxis, and to compare
outcomes with traditional methods. The primary objective of this study is to assess the clinical
efficacy and safety of endoscopic techniques in the management of epistaxis, particularly in
patients with recurrent or posterior nasal bleeding that is refractory to conventional treatment
methods. This research aims to systematically evaluate the role of endoscopic intervention, such
as endoscopic cauterization and sphenopalatine artery ligation (ESPAL), in achieving
hemostasis, reducing recurrence rates, and minimizing complications.
In recent years, endoscopic methods have gained significant popularity due to their
minimally invasive nature and the enhanced visualization they provide of the nasal cavity and
bleeding sources. However, despite their increasing use, there is still a need for comprehensive
clinical evaluation to determine their long-term effectiveness, patient outcomes, and potential
advantages over traditional anterior and posterior nasal packing techniques.
Specifically, the study is designed to:
Investigate the anatomical sources of epistaxis using endoscopic visualization.
Evaluate the success rate of various endoscopic procedures in controlling epistaxis.
Analyze perioperative and postoperative complications, including pain, infection, and
mucosal damage.
Compare patient comfort and satisfaction between endoscopic and conventional
management methods.
Explore correlations between comorbid conditions (e.g., hypertension, coagulopathies)
and treatment outcomes.
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Develop evidence-based recommendations for otorhinolaryngologists in the
management of complex epistaxis cases.
Through this study, we aim to contribute to a better understanding of how modern
endoscopic interventions can optimize care for patients suffering from acute or recurrent
nosebleeds, improve prognosis, and
Materials and Methods
A prospective study was conducted over a period of 9 months at the Department of
Otorhinolaryngology No. 2, Samarkand State Medical University. A total of 42 patients with
active epistaxis (23 anterior, 19 posterior) were included in the study.
Inclusion Criteria:
- Patients aged 18–70 years with spontaneous or trauma-induced epistaxis
- Refractory to first-line conservative treatment (nasal packing)
Exclusion Criteria:
- Coagulopathy disorders
- Neoplastic or vascular malformations
Methodology
:
- Initial management included anterior or posterior nasal packing depending on bleeding
site
- Patients with recurrent or persistent bleeding underwent diagnostic nasal endoscopy
- Bleeding vessels (mostly branches of the sphenopalatine artery) were cauterized or
clipped
- Patients were followed for up to 3 months post-procedure for recurrence and
complications
Results
Out of 42 patients:
- 33 required endoscopic intervention
- Successful hemostasis was achieved in 31 out of 33 (94%) without recurrence during
follow-up
- Minimal complications were observed:
- 1 patient with mild nasal synechiae
- 1 patient experienced crusting, managed conservatively
- Hospital stay was significantly shorter in the endoscopic group (2.1 days vs 4.5 days
in packing group)
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Discussion
Epistaxis, though common, can be life-threatening in posterior cases. Traditional nasal
packing is often uncomfortable and associated with longer hospital stays and higher recurrence
rates.
Endoscopic cauterization or ligation allows direct visualization of bleeding points,
offering precise, minimally invasive, and highly effective treatment.
This study confirms that endoscopic management is superior to traditional methods in
terms of efficacy, patient comfort, hospital stay, and complication rates.
Conclusion
Endoscopic management of epistaxis is a safe, effective, and patient-friendly approach
with high success rates and low recurrence. It should be considered early in patients
unresponsive to conservative measures.
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