Epistaxis

Clinical Case

Epistaxis Control

Laser Used

Epic-S Diode Laser 940 nm

Accessory Used

400 um bare fiber tip, non-initiated, clear tip, 30mm long
Surgery handpiece

Treatment Parameters

3 Watt CW
Non-contact ablation with clear (white) tip

Authored by Physician

Yosef Krespi, MD
Professor of Otolaryngology, Hofstra School of Medicine, New York

Patient Symptoms

Unilateral generally, nasal bleeding. May cause anemia when prolonged. More often in winter time or when dry conditions occur.

Diagnosis

Treatment with laser is not for the acute phase. Engorged blood vessels generally in Kiesselbach`s area of anterior septum, on the bleeding side with possible ulceration, but can occur on any site including nasal turbinates.

Management

Vessel sealing can be attempted with the laser when no active bleeding is seen. The laser will ablate the prominent vasculature in the non contact mode. Power is minimal and delivered with short tip with un-initiated tip. The treated area will bleach (coagulate) and vessels involute.

Laser Surgery, Pre-Op

Anesthesia is achieved with a topical application of a mixture of lidocaine 2% and neosynephrine, followed by injection of 2% lidocaine with epinephrine 1:100,000. Sublabial injection may be necessary.