title: On the effectiveness of treatment options in epistaxis: an analysis of 678 interventions.
abstract: BACKGROUND
  Epistaxis represents one of the most common emergencies in ENT clinics around the world. It creates great physical and emotional stress to the patient as well as a financial burden on health-care systems. A lot of research has been performed with regard to aetiology and possible treatment, however, not much effort has been put into analysing the effectiveness of common treatment forms. It is the objective of this study to clarify which of these treatment forms is reliable.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  2b.
  
  
  METHODS
  Between 03/2007 and 04/2008, all epistaxis therapies including relapses and treatment failures at the University Hospital of Zurich have been documented using a computerised questionnaire. Different treatments were compared to each other.
  
  
  RESULTS
  An analysis of 678 interventions in 537 patients was performed with emphasis on failure proportions and time to occurrence. The estimated failure proportions of coagulation in anterior epistaxis accounts for 14%. Successful treatment of epistaxis in posterior bleedings could be achieved in 62% by packing and in 97% by surgery with a statistically significant difference between the respective groups.
  
  
  CONCLUSIONS
  Using our treatment options, anterior epistaxis can be cured reliably by cauterisation. Surgical therapies in posterior bleedings are able to successfully salvage failed packing therapies.
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, Switzerland. micheal@soyka.ch
authors: M B
authors: MB
authors: Soyka
authors: G
authors: G
authors: Nikolaou
authors: K
authors: K
authors: Rufibach
authors: D
authors: D
authors: Holzmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004564:Electrocoagulation; D004844:Epistaxis / Q000601:surgery / Q000628:therapy*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C411004:FloSeal Matrix