title: Comparison of outcomes between endoscopic surgery and conventional nasal packing for epistaxis in the posterior fornix of the inferior nasal meatus.
abstract: OBJECTIVE
  To investigate the clinical features of epistaxis in the posterior fornix of the inferior nasal meatus and compare the treatment outcomes of endoscopic surgery and conventional nasal packing for this intractable form of epistaxis.
  
  
  METHODS
  Between August 2011 and August 2014, the medical records of 53 adult patients with idiopathic epistaxis in the posterior fornix of the inferior nasal meatus diagnosed by nasal endoscopy were obtained from our department. Of these, 38 patients underwent endoscopic surgery (surgery group) and 15 received a nasal pack (packing group). The patients' background characteristics, incidence of re-bleeding, extent of discomfort after treatment as assessed using a 10-point visual analogue scale (VAS) and incidence of nasal cavity adhesion after treatment were analysed.
  
  
  RESULTS
  There were no significant differences in background characteristics between the two groups. The incidence of re-bleeding (0/38 vs. 4/15, surgery vs. control, P = 0.001), VAS score for discomfort (2.4 ± 1.4 vs. 7.6 ± 1.0, surgery vs. control, P = 0.001) and incidence of nasal cavity adhesion after treatment (2/38 vs. 7/15, surgery vs. control, P = 0.007) were significantly lower in the surgery group than in the packing group.
  
  
  CONCLUSIONS
  Endoscopic surgery is superior to conventional nasal packing for the management of epistaxis in the posterior fornix of the inferior nasal meatus. During surgery, it is crucial to expose the bleeding sites by shifting the inferior turbinate inward by fracture.
authors: You Zou, Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
authors: You
authors: Y
authors: Zou
authors: Yu-Qin Deng, Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
authors: Yu-Qin
authors: YQ
authors: Deng
authors: Chang-Wu Xiao, Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
authors: Chang-Wu
authors: CW
authors: Xiao
authors: Yong-Gang Kong, Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
authors: Yong-Gang
authors: YG
authors: Kong
authors: Yu Xu, Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
authors: Yu
authors: Y
authors: Xu
authors: Ze-Zhang Tao, Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
authors: Ze-Zhang
authors: ZZ
authors: Tao
authors: Shi-Ming Chen, Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
authors: Shi-Ming
authors: SM
authors: Chen
keywords: Electrocautery; Endoscopy; Epistaxis; Inferior nasal meatus; Posterior fornix