title: Incidence and management of epistaxis after endoscopic skull base surgery.
abstract: OBJECTIVE
  Endonasal endoscopic surgery continues to gain acceptance as a minimally invasive, effective approach for benign and malignant pathology of the paranasal sinuses and skull base. Postoperative epistaxis could potentially result in rapid and devastating consequences due to hemorrhage. Our objective was to assess the incidence and causes of epistaxis after endoscopic skull base surgery.
  
  
  METHODS
  Retrospective review of patients undergoing endoscopic skull base surgeries from 2007 to 2012. The main outcome measure was epistaxis requiring a visit to a hospital or clinic occurring within 30 days of surgery.
  
  
  RESULTS
  In our cohort of 330 consecutive patients, 10 (3%) experienced postoperative epistaxis, including 3 who had multiple episodes (14 events). A majority of the patients were controlled with packing in the emergency room (8/14 events). One patient required chemical cautery and 5 required control in the operating room. The only patient characteristic that reached significance was abstinence from alcohol (p value = 0.04). However, patients with epistaxis were more likely to be male, older and have hypertension.
  
  
  CONCLUSIONS
  This study confirms that the risk of epistaxis after endoscopic skull base surgery is low and similar to sinonasal surgery for inflammatory conditions.
authors.affiliation: Departments of Head and Neck Surgery, University of California, Los Angeles, Calif. 90095-1624, USA. chrthompson@mednet.ucla.edu
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Thompson
authors.forename: Marilene B
authors.initials: MB
authors.lastname: Wang
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Kim
authors.forename: Marvin
authors.initials: M
authors.lastname: Bergsneider
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Suh
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D003397:Craniopharyngioma / Q000601:surgery; D004844:Epistaxis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D019291:Skull Base / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000601:surgery*