title: Bilateral epistaxis in children: efficacy of bilateral septal cauterization with silver nitrate.
abstract: OBJECTIVE
  To evaluate the rate of control of epistaxis in patients with bilateral complaints using silver nitrate and to assess short-term complications from this therapy.
  
  
  METHODS
  Retrospective chart review with prospective incident case identification in a tertiary referral pediatric otolaryngology practice.
  
  
  METHODS
  Forty-six consecutive patients presenting to a single pediatric otolaryngologist with complaints of bilateral epistaxis received bilateral silver nitrate cauterization to the anterior septum and were seen in follow-up 2 months later to assess for control of epistaxis and complications from this therapy.
  
  
  RESULTS
  Ninety-three percent (43/46) of patients followed-up at 2 months after therapy. About 93% (40/43) had total or near-total resolution of their epistaxis. Five percent (2/43) of patients returned to the clinic after initial successful control for a second cauterization during the period of study. No significant complications of infection, perforation, long-term crusting, tattooing or mucocutaneous or allergic reactions were identified.
  
  
  CONCLUSIONS
  Bilateral epistaxis can be treated at a single visit with bilateral silver nitrate therapy in children. This treatment is highly effective, well-tolerated, and appears to have a low rate of complications.
authors.affiliation: Division of Pediatric Otolaryngology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: T Roxanne
authors.initials: TR
authors.lastname: Link
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Conley
authors.forename: Valerie
authors.initials: V
authors.lastname: Flanary
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kerschner
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002425:Cautery / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004844:Epistaxis / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009300:Nasal Septum; D012189:Retrospective Studies; D012835:Silver Nitrate / Q000627:therapeutic use*
chemical_list: D000890:Anti-Infective Agents; D012835:Silver Nitrate