ear, nose, and throat disorders
How To Treat Posterior Epistaxis With a Balloon
Introduction
Posterior epistaxis (nasal hemorrhage) can often be controlled with balloon tamponade. Epistaxis may be due to bleeding from the anterior or posterior nasal passage. Anterior bleeding is much more common, but posterior bleeding is more dangerous and is managed differently; thus, identifying the site of bleeding is critical. Epistaxis that persists without an evident anterior nasal source is most often caused by a posterior bleeding site. Posterior bleeding is sometimes controlled using topical vasoconstrictors. If not, it usually requires treatment with nasal packing. Historically, gauze packing was used but balloon tamponade is easier to do and more comfortable to the patient and thus is usually preferred. Some balloons can occlude both the anterior and posterior nasal cavity simultaneously. (SeeClinical Practice Guideline: Nosebleed (Epistaxis).) Posterior nasal packing is very uncomfortable. Intravenous sedation and analgesia are often needed and hospitalization is required. Applying a cardiac monitor and Pulse Oximetry is strongly recommended. (See Epistaxis , 