title: A Comparison of Bipolar Electrocautery and Chemical Cautery for Control of Pediatric Recurrent Anterior Epistaxis.
abstract: OBJECTIVE
  To compare the outcome of children with anterior epistaxis treated intraoperatively with either bipolar electrocautery or silver nitrate chemical cautery.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary-care pediatric otolaryngology practice.
  
  
  METHODS
  Children aged 2 to 18 years treated with either intraoperative bipolar electrocautery or silver nitrate chemical cautery of the anterior nasal septum for recurrent anterior epistaxis.
  
  
  METHODS
  Any reported bleeding event after surgery was recorded. The mean time from surgery to recurrent epistaxis was compared between groups.
  
  
  RESULTS
  Fifty patients underwent bipolar electrocautery, while 60 patients underwent silver nitrate chemical cautery. Within 2 years, 1 (2%) patient in the bipolar electrocautery group and 13 (22%) patients in the silver nitrate chemical cautery group had recurrent epistaxis (P = .003). Two years after treatment, there was no difference between treatment groups. Overall, 4 patients (8%) had recurrent epistaxis postoperatively in the bipolar electrocautery group at a mean of 4.34 years after treatment, while 17 (28.3%) patients recurred after a mean of 1.53 years of treatment in the silver nitrate chemical cautery group (P = .01).
  
  
  CONCLUSIONS
  Compared to those treated with chemical cautery, those treated with bipolar electrocautery had a longer nosebleed-free period and a lower incidence of recurrent epistaxis within 2 years of treatment. Beyond 2 years, the treatment methods are equivocal. Bipolar electrocautery may be a superior treatment in children who will not tolerate in-office chemical cautery, in those with a risk of severe bleeding, or when it can be combined with other operative procedures.
authors.affiliation: Department of Otolaryngology, University at Buffalo, Buffalo, New York, USA nathanjohnson1010@gmail.com.
authors.forename: Nathan
authors.initials: N
authors.lastname: Johnson
authors.affiliation: Department of Otolaryngology, University at Buffalo, Buffalo, New York, USA.
authors.forename: John
authors.initials: J
authors.lastname: Faria
authors.affiliation: Department of Otolaryngology, University at Buffalo, Buffalo, New York, USA Pediatric Ear, Nose and Throat Associates, Amherst, New York, USA.
authors.forename: Philomena
authors.initials: P
authors.lastname: Behar
mesh_terms: D000293:Adolescent; D002425:Cautery / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation; D004844:Epistaxis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome
keywords: epistaxis; pediatric otolaryngology; sinonasal disorders