NOSE BLEEDS (EPISTAXIS)
At least once in the lifetime we all have had an abnormal condition when blood starts to come from your nose. This may be a result of nose trauma, blood vessels disease or speedy pressure change, etc. Doctors call this condition epistaxis. Nosebleed symptoms include haemorrhage from one of the nostrils together with blood dripping at the back of the throat. Epistaxis treatment aims, first of all, to stop the bleeding, provide for healing of the damaged tissues and prevent possible nosebleeds recurrence. Let`s review this condition and available options to treat it in more detail below.
Bleeding through the nostrils, nasopharynx and nasal cavity is called epistaxis.
Nosebleeds occur when a blood vessel in the nose bursts as a result of a trauma inducing event. Although nose bleeds are not likely to lead to death and stop on their own, their sources differ from the back of the nose and the front of the nose.
SOURCE OF NOSE BLEEDS (EPISTAXIS)
The nasal cavity serves as home to several blood vessels and blood flow comes from both the back and front of the nose. The major arteries in the nasal cavity include the anterior and posterior ethmoid arteries and the sphenopalatine arteries. Almost 100% of the nosebleeds occur in the anteroinferior (front bottom) which is close to the nasal septum (the wall that divides your nose between left and right sides), in an area known as Kiesselbach’s plexus, which was named after a German otolaryngologist named Wilhelm Kiesselbach.
THREE TYPES OF NOSE BLEEDS (EPISTAXIS)
- Local: Trauma, mucosal irritation, septal abnormality, inflammatory diseases and tumors
- Systemic: Blood disorders, arteriosclerosis, hereditary hemorrhagic telangiectasia, and unknown causes.
- Facial trauma: Foreign bodies, nasal or sinus infections, and the continuous inhalation of dry air.
Local trauma happens to be the most common cause of nosebleeds accompanied by facial trauma. Other causes of nosebleeds include tumors, vascular malformations and holes in the nasal septum.
Nose bleeds are usually restricted to one of the nostrils but some cases of heavy bleeding would lead to the entire nostril filling up which would then overflow to the nasopharynx and make it appear like both nostrils are bleeding. The blood flow can also extend to the back of the throat and enter the stomach which causes the affected individual to vomit blood. The signs indicated are:
EPISTAXIS TREATMENT OPTIONS
Treatment of epistaxis is only required when there is a severe or recurrent case of bleeding. The affected individual’s treatment is carried out based on previous medical reports, unique circumstance, availability of needed services and the doctor’s scope.
Most situations just require the use of nasal packing and cauterization. Alternative treatment options are only looked into when the case of bleeding does not respond to simple treatment. As a result, embolization or surgery accompanied with close monitoring is suggested.
The treatment of epistaxis includes options like:
- Topical and oral antibiotics which help to wards off toxic shock and rhinosinusitis
- Complete abstinence from drugs that are anti-inflammatory and have steroid components like aspirin
- Choosing suitable medication that can restrain any existing medical problem like hypertension
- Control of pain with methods like nasal packing
DIAGNOSING NOSE BLEEDS (EPISTAXIS)
- History taking physical exam: The doctor does an examination to locate the position of the nose bleed and whether it is at the front end or back end of the nose. The cause of the nose bleed is also something researched and medication or treatment is done on the basis of the results and medical history.
- Nasal endoscopy: Nasoendoscopy is a minimally invasive, medical procedure carried out to diagnose any nasal conditions. It helps to examine the interior surfaces of the nose and allows visualization of its cavities not possible by standard examination.The procedure is performed with the help of a nasal endoscope which is a medical device consisting of a thin, rigid tube with fiberoptic cables to light-up the inside of the nose. The endoscope is then connected to a light source and a video camera to project magnified images on a screen. During the procedure your doctor may capture or record the images for further documentation.