A Clinical Study of Aetiopathogenesis and Management of Epistaxis

Abstract

Background: Epistaxis is one of the most common emergencies encountered in otorhinolaryngology, with multifactorial etiologies ranging from local trauma to systemic disorders. Despite being usually benign, recurrent or severe epistaxis can be life-threatening and requires prompt evaluation and management.

Aim: To evaluate the aetiopathogenesis and management of epistaxis in patients presenting to a tertiary care center.

Materials and Methods: This prospective observational study included 150 patients presenting with epistaxis to the Department of ENT at Andaman institute of medical sciences,portblair. Detailed history, clinical examination, and relevant investigations were performed to identify etiological factors. Management strategies were individualized, ranging from conservative measures (cautery, anterior nasal packing) to surgical or interventional approaches (posterior packing, endoscopic sphenopalatine artery ligation, embolization). Patients were followed up for short-term outcomes, including hemostasis, recurrence, and hospital stay. Statistical analysis was performed using chi-square and t-tests, with p < 0.05 considered significant.

Results: The mean age was 39.4 ± 17 years, with a male predominance (72.7%). Anterior epistaxis constituted 88.7% of cases, while posterior bleeds accounted for 11.3%. Trauma (64.7%) was the most common etiology, followed by hypertension (14.0%) and neoplasms (8.0%). Conservative treatment achieved hemostasis in 84.7% of patients within 24 hours, with a rebleed rate of 12.7%. Surgical or interventional measures were required in 25.3% of cases, with endoscopic cautery and ESPAL showing success rates above 85%. The mean hospital stay was 2.43 ± 1.32 days, significantly shorter in conservatively managed patients compared to surgical groups.

Conclusion: Epistaxis most commonly affects younger adult males and is predominantly anterior and trauma-related. Conservative treatment remains highly effective, while surgical or interventional techniques are reserved for refractory cases with excellent outcomes. A stepwise, cause-oriented approach ensures optimal patient care.