KEY WORDS: Posterior fornix, Inferior nasal meatus, Epistaxis, Endoscopy, Electrocautery.
The effectiveness of conventional packing of the anterior or posterior nares for the control of epistaxis in the posterior fornix of the inferior nasal meatus (a type of intractable posterior epistaxis) is reportedly unsatisfactory.4 The management of posterior epistaxis is quite challenging for physicians and may be extremely painful for the patient.
In this study, we investigated the clinical features of epistaxis in the posterior fornix of the inferior nasal meatus and compared the outcomes of endoscopic surgery and conventional nasal packing for this intractable form of epistaxis.
The exclusion criteria were as follows: age less than 20 years, bleeding from sites other than the posterior fornix of the inferior nasal meatus.8
During surgery, the patient was placed in the supine position, the nasal pack was removed under endoscopic guidance and the bleeding points, particularly those located in the olfactory fissure, sphenoethmoidal recess and middle nasal meatus, were clearly examined from a craniocaudal perspective after the application of topical anaesthesia using tetracaine and oxymetazoline hydrochloride spray (Fig.1a).