Comparison of Topical Treatments and Chemical Cauterization for Recurrent Anterior Epistaxis in Pediatric Patients

Abstract

Objective: To compare the effectiveness of topical treatment methods versus chemical cauterization in managing recurrent anterior epistaxis in pediatric patients.
Study Design: Comparative cross sectional study design
Place and Duration of Study: ENT Department of Imran Idrees Teaching Hospital, Sialkot, from 15th June 2023 to 30th December 2023.
Materials and Methods: Eighty individuals, aged 5 to 18 years, with recurrent anterior epistaxis (≥4 episodes in the past month) were enrolled in the study and randomly assigned to two groups using a lottery method. Patients with coagulation disorders, chronic nasal conditions, autoimmune diseases, use of anticoagulant medications, or significant nasal structural abnormalities were excluded. Group A (n=40) underwent 75% silver nitrate chemical cautery of the anterior nasal septum, while Group B (n=40) received a week-long topical treatment consisting of 0.05% xylometazoline and a local oil-based antibacterial ointment. All patients were monitored for one month after treatment, with follow-up visits scheduled for two and four weeks. Data were analyzed using SPSS version 23, with quantitative variables expressed as mean ± standard deviation and qualitative variables as frequencies and percentages. The chi-square test was used to compare treatment efficacy with statistical significance set at p < 0.05.
Results: The average age of study participants was 14.24 ± 2.620 years. There were 43 (40%) men and 48 (60%) women patients. The therapy was effective in 75% of Group A and in 65% of Group B.
Conclusion: Although chemical cauterization resulted in a higher number of successful cases, there was no statistically significant difference between chemical cauterization and local antiseptic ointment at the 30-day post-treatment mark. Consequently, local antiseptic ointment can be considered a viable alternative when cauterization is not feasible.