title: Massive pneumocephalus following Merocel nasal tamponade for epistaxis.
abstract: Anterior epistaxis is commonly treated with Merocel nasal tampon insertion in preference to gauze packing. An 89-year-old patient was found to have cerebrospinal fluid rhinorrhea and massive pneumocephalus immediately after removal of a Merocel tampon used for spontaneous anterior epistaxis. She later developed fever and mild confusion, but was well at three-month follow-up. The advantages and complications of Merocel nasal tamponade are briefly reviewed and compared with those of other methods of control of anterior epistaxis.
authors.affiliation: Department of Emergency Medicine, St. George Hospital, Sydney, Australia. hollisg@sesahs.nsw.gov.au
authors.forename: G J
authors.initials: GJ
authors.lastname: Hollis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology*; D004844:Epistaxis / Q000628:therapy*; D005260:Female; D005557:Formaldehyde / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology*; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D013630:Tampons, Surgical; D014057:Tomography, X-Ray Computed
chemical_list: D006490:Hemostatics; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol