دورية أكاديمية
Systematic endoscopic assessment of bleeding sites in severe epistaxis: the role of the S-point and the superior epistaxis.
| العنوان: | Systematic endoscopic assessment of bleeding sites in severe epistaxis: the role of the S-point and the superior epistaxis. |
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| المؤلفون: | Loures CN; Federal University of Sao Paulo (UNIFESP-EPM), Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, SP, Brazil., Castro TC; Federal University of Sao Paulo (UNIFESP-EPM), Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, SP, Brazil., Luz-Matsumoto GR; Federal University of Sao Paulo (UNIFESP-EPM), Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, SP, Brazil., Siebert VS; Federal University of Sao Paulo (UNIFESP-EPM), Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, SP, Brazil., Lacerda LS; Federal University of Sao Paulo (UNIFESP-EPM), Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, SP, Brazil., Miranda MV; Federal University of Sao Paulo (UNIFESP-EPM), Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, SP, Brazil., Tepedino MS; Botafogo Polyclinic, Department of Otorhinolaryngology, Rio de Janeiro, RJ, Brazil., Balsalobre L; Federal University of Sao Paulo (UNIFESP-EPM), Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, SP, Brazil; Edmundo Vasconcelos Hospital Complex, Otorhinolaryngology, Sao Paulo, SP, Brazil., Stamm AC; Edmundo Vasconcelos Hospital Complex, Otorhinolaryngology, Sao Paulo, SP, Brazil., Kosugi EM; Federal University of Sao Paulo (UNIFESP-EPM), Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, SP, Brazil. |
| المصدر: | Rhinology [Rhinology] 2020 Oct 01; Vol. 58 (5), pp. 477-481. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: International Rhinologic Society Country of Publication: Netherlands NLM ID: 0347242 Publication Model: Print Cited Medium: Print ISSN: 0300-0729 (Print) Linking ISSN: 03000729 NLM ISO Abbreviation: Rhinology Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Leiden : International Rhinologic Society |
| مواضيع طبية MeSH: | Endoscopy* , Epistaxis*/therapy, Humans ; Longitudinal Studies ; Nasal Cavity ; Prospective Studies |
| مستخلص: | Background: Systematic endoscopic assessment (SEA) of bleeding sites is critical for topodiagnosis and treatment of severe epistaxis, which is not limited to the posterior region. A bleeding site originating from the ethmoidal vasculature, the S-point, has recently been described. The aim of this study is to ascertain the prevalence of each bleeding site in severe epistaxis using a SEA protocol that includes the S-point. Methodology: Prospective longitudinal study of 51 severe epistaxis patients who underwent 53 SEA under general anesthesia from April 2018 through March 2019. SEA consisted of use of a rigid nasal endoscope; no reduction in blood pressure; no use of topical vasoconstrictor; systematic search of all regions of the nose. Bleeding sites were assigned to either superior or posterior epistaxis. Results: At least one bleeding site was identified in 37 evaluations (69.8%). The S-point was the most common bleeding site (28.3%), followed by the lateral middle turbinate (9.4%), non-S-point upper septum (7.5%), nasal roof (7.5%), and upper lateral wall (7.5%). Superior epistaxis was identified in the most of cases (27 SEA, 50.9%), whereas only 14 SEA (26.4%) identified posterior epistaxis â€" fewer than the 16 SEA that did not identify any bleeding sites (30.2%). There were two recurrences (3.8%). Conclusions: Systematic endoscopic assessment effectively identified bleeding sites in 69.8% of severe epistaxis. The S-point was the most common bleeding site identified (28.3%). Finally, superior epistaxis corresponded to more than half of the identified bleeding sites, demonstrating the importance of examining this region judiciously in patients with severe epistaxis. |
| تواريخ الأحداث: | Date Created: 20200506 Date Completed: 20210114 Latest Revision: 20210114 |
| رمز التحديث: | 20221213 |
| DOI: | 10.4193/Rhin19.466 |
| PMID: | 32369538 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 0300-0729 |
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| DOI: | 10.4193/Rhin19.466 |