title: Comparison of Local Sclerotherapy With Lauromacrogol Versus Nasal Packing in the Treatment of Anterior Epistaxis.
abstract: OBJECTIVE
  Epistaxis is one of the most common otorhinolaryngologic emergencies representing more than 12% of conditions managed at the Ear, Nose and Throat (ENT) Emergency Consulting Room of our Otorhinolaryngologic Unit each year. The elevated frequency of this pathology makes it necessary to adopt the most effective and least expensive therapeutic strategy available. The aim of this study was to compare the efficacy, costs and morbidity of nasal packing (NP), which is the mainstay of treatment for anterior epistaxis in our ENT Emergency Consulting Room versus submucosal infiltrations of lauromacrogol (LA).
  
  
  METHODS
  A retrospective study was designed from August 2012 to April 2013 involving 53 patients suffering from anterior epistaxis. Anterior NP was used in 27 patients versus 26 patients undergoing 27 procedures performed with submucosal infiltrations of LA (or polidocanol). Outcomes for each treatment were evaluated. Patients in group 1 were treated with LA 400 injection next to the bleeding point: 0.5- to 1-mL single or multiple infiltrations with a 27-gauge needle. The whitening of the nasal mucosa around the bleeding point during infiltration was considered a marker of correct procedure in order to achieve the best results. Bilateral treatment was also performed at the same time. Patients in group 2 were treated with standard NP.
  
  
  RESULTS
  Bleeding recurrence was higher in the NP group even if it was not statistically significant (P=0.2935). However, the LA infiltrations were better tolerated with lower morbidity and costs as compared to NP. No complications were observed in either group.
  
  
  CONCLUSIONS
  LA infiltrations were shown to be a viable alternative in anterior epistaxis treatment. They are safe, easy to use with good efficacy and have a low cost.
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, Bologna University Medical School, Bologna, Italy.|Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Farneti
authors.affiliation: Ear, Nose and Throat Metropolitan Unit, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Pasquini
authors.affiliation: Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Sciarretta
authors.affiliation: Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Macrì
authors.affiliation: Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Gramellini
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, Bologna University Medical School, Bologna, Italy.|Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pirodda
keywords: Epistaxis; Nasal Mucosa; Polidocanol; Polyethylene Glycol; Sclerotherapy