ear, nose, and throat disorders
How To Treat Posterior Epistaxis With a Balloon
Additional Considerations for Treating Posterior Epistaxis With a Balloon
Initiate treatment for any hypovolemia or shock before treating epistaxis. Ask about use of anticoagulant or antiplatelet drugs. Check complete blood count (CBC), prothrombin time (PT), and partial thromboplastin time (PTT) if there are symptoms or signs of a bleeding disorder or patient has severe or recurrent epistaxis. If posterior packing fails to control nasal hemorrhage, invasive methods done by specialists may be needed: Sphenopalatine artery (SPA) ligation, typically done using a transnasal endoscopic approach; success rates exceed 85% ( References ) Endovascular SPA embolization; reported success rate 88% ( References ). Endoscopic SPA ligation is done by an otolaryngologist and has a lower risk of major complications (eg, stroke, blindness) than endovascular SPA embolization and may be more appropriate for patients who can safely tolerate general anesthesia or if the embolization procedure is not readily available. Endovascular SPA embolization is done by an interventional radiologist under local anesthesia and may be better for patients with multiple comorbidities that preclude safe general anesthesia, for those on anticoagulant therapy, and for patients who present with bleeding after previously having had endoscopic SPA ligation. 