Muhammad Ismail Khan, Mohammad, Rafique Khattak.
Control of Unilateral Spontaneous Anterior Epistaxis: Comparison of Complications of Anterior Nasal Packing Versus Silver Nitrate Cautery.
Pak J Med Health Sci Jan ;6(4):823-6.

Objective: To compare anterior nasal packing (ANP) versus silver nitrate cautry (SNC) in controlling spontaneous unilateral anterior epistaxis in terms of complications. Materials and methods: This analytical study was conducted at Department of ENT, DHQ Hospital, Lakki Marwat from August 2007 to July 2010. Patients of any gender and age with spontaneous unilateral anterior epistaxis were included in the study. Patients with bilateral anterior epistaxis, posterior epistaxis, post-traumatic epistaxis, and epistaxis due to neoplastic or hereditary haematologic disorders were excluded. Patients were divided into group 1 and 2 of 50 each on alternate basis. Data was collected for gender, age, recurrence of bleeding, pain, infection, exposure of septal cartilage, breathing difficulty and facial edema and was analyzed for differences between groups by using unpaired t test for numeric data while Chi-Square for nominal data. Results: Out of 100 patients 67 were male and 33 female with male preponderance. Mean age of the patients was 36.56±24.83 years in group 1 and 36.52±25.44 years in group 2 (p= 0.994). Age group 05-10 years was most frequently involved. Pain, breathing difficulty and facial edema were statistically significantly lower in group 1 (p=0.025, 0.025, 0.041 respectively) while the difference for recurrence of bleeding, infection and exposure of septal cartilage were non significant. Conclusions: The decreased post procedure morbidity associated with SNC makes it a superior procedure over ANP for managing spontaneous unilateral anterior epistaxis.

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