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Intranasal cautery for the management of adult epistaxis: systematic review.

Abstract Cauterisation techniques are commonly used and widely accepted for the management of epistaxis. This review assesses which methods of intranasal cautery should be endorsed as optimum treatment on the basis of benefits, risks, patient tolerance and economic assessment.
PMID
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Authors

Mayor MeshTerms
Keywords

Cautery

Electrocoagulation

Epistaxis

Therapy

Journal Title the journal of laryngology and otology
Publication Year Start




PMID- 29280692
OWN - NLM
STAT- MEDLINE
DCOM- 20180102
LR  - 20180102
IS  - 1748-5460 (Electronic)
IS  - 0022-2151 (Linking)
VI  - 131
IP  - 12
DP  - 2017 Dec
TI  - Intranasal cautery for the management of adult epistaxis: systematic review.
PG  - 1056-1064
LID - 10.1017/S0022215117002043 [doi]
AB  - BACKGROUND: Cauterisation techniques are commonly used and widely accepted for
      the management of epistaxis. This review assesses which methods of intranasal
      cautery should be endorsed as optimum treatment on the basis of benefits, risks, 
      patient tolerance and economic assessment. METHOD: A systematic review of the
      literature was performed using a standardised methodology and search strategy.
      RESULTS: Eight studies were identified: seven prospective controlled trials and
      one randomised controlled trial. Pooling of data was possible from 3 studies,
      yielding a total of 830 patients. Significantly lower re-bleed rates were
      identified (p < 0.01) using electrocautery (14.5 per cent) when compared to
      chemical cautery (35.1 per cent). No evidence suggested that electrocautery was
      associated with more adverse events or discomfort. Limited evidence supported the
      use of a vasoconstrictor agent and operating microscope during the procedure. The
      included studies had considerable heterogeneity in terms of design and outcome
      measures. CONCLUSION: Consistent evidence suggests that electrocautery has higher
      success rates than chemical cautery, and is not associated with increased
      complications or patient discomfort. Lower quality evidence suggests that
      electrocautery reduces costs and duration of hospital stay.
FAU - Mcleod, R W J
AU  - Mcleod RWJ
AD  - ENT Department,University Hospital of Wales,Cardiff,UK.
FAU - Price, A
AU  - Price A
AD  - ENT Department,University Hospital of Wales,Cardiff,UK.
FAU - Williams, R J
AU  - Williams RJ
AD  - Institute of Naval Medicine,Gosport,UK.
FAU - Smith, M E
AU  - Smith ME
AD  - Department of Otolaryngology,Addenbrooke's Hospital,Cambridge,UK.
FAU - Smith, M
AU  - Smith M
AD  - Exeter Health Library,Peninsula Medical School,UK.
FAU - Owens, D
AU  - Owens D
AD  - ENT Department,University Hospital of Wales,Cardiff,UK.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - England
TA  - J Laryngol Otol
JT  - The Journal of laryngology and otology
JID - 8706896
SB  - AIM
SB  - IM
MH  - Adult
MH  - Cautery/economics/*methods
MH  - Electrocoagulation/economics/methods
MH  - Endoscopy/economics/*methods
MH  - Epistaxis/economics/*surgery
MH  - Humans
MH  - Outcome and Process Assessment (Health Care)/economics
MH  - Patient Admission/economics
MH  - Recurrence
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cautery
OT  - Electrocoagulation
OT  - Epistaxis
OT  - Therapy
EDAT- 2017/12/28 06:00
MHDA- 2018/01/03 06:00
CRDT- 2017/12/28 06:00
PHST- 2017/12/28 06:00 [entrez]
PHST- 2017/12/28 06:00 [pubmed]
PHST- 2018/01/03 06:00 [medline]
AID - S0022215117002043 [pii]
AID - 10.1017/S0022215117002043 [doi]
PST - ppublish
SO  - J Laryngol Otol. 2017 Dec;131(12):1056-1064. doi: 10.1017/S0022215117002043.