title: Contemporary perspectives on the management of posterior epistaxis: survey of canadian otolaryngologists.
abstract: OBJECTIVE
  To describe current management of posterior epistaxis among Canadian otolaryngology-head and neck surgeons.
  
  
  METHODS
  A cross-sectional Internet-based survey was distributed to all 550 members of the Canadian Society of Otolaryngology-Head and Neck Surgery with an electronic mail contact. The survey consisted of three sections: (1) demographic data, (2) opinions regarding management options for posterior epistaxis, and (3) opinions regarding management of complications after placement of a posterior nasal pack. The survey was available for completion from July 2009 until October 2009. Main outcome measures were ranking of preference, comfort level, and perceived best management option for posterior epistaxis.
  
  
  RESULTS
  A total of 152 completed surveys were collected (28% response rate). Respondents were most comfortable with and most preferred inflatable balloon packing for treatment of posterior epistaxis. However, it was felt that endoscopic sphenopalatine arterial ligation was the best available intervention. After placement of a posterior nasal pack, respondents felt that monitoring of vital signs was required for all patients, but a lower-intensity monitoring setting may be sufficient.
  
  
  CONCLUSIONS
  There is a discrepancy between actual practice and perceived best available management for posterior epistaxis. Respondents also favoured a lower-intensity monitoring setting for patients with posterior nasal packing. Practice guidelines may be helpful in ensuring that patients receive the best possible care while making the best use of limited hospital resources.
authors.affiliation: Department of Otolaryngology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON.
authors.forename: Samantha
authors.initials: S
authors.lastname: Tam
authors.forename: Brian
authors.initials: B
authors.lastname: Rotenberg
mesh_terms: D002170:Canada; D003430:Cross-Sectional Studies; D003625:Data Collection; D004844:Epistaxis / Q000601:surgery / Q000628:therapy*; D006489:Hemostatic Techniques; D006801:Humans; D010036:Otolaryngology