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Postoperative Epistaxis Following Dental Treatment With Nitrous Oxide/Oxygen Sedation
Ishfaq Khan BDS, MFDS (RCPS), DSCD (RCSEd)
Article Category: Case Report
Volume/Issue: Volume 70: Issue 2
Online Publication Date: Jun 28, 2023
DOI: 10.2344/anpr-70-01-04
Page Range: 75 – 79

Epistaxis is fairly common in adults and children as the blood vessels supplying the nasal mucosa have little anatomic support or inherent protection. The most common causes of epistaxis in children include nasal mucosal dryness, trauma, foreign body, and rhinitis. Other important potential causes that are less common include systemic conditions such as bleeding or inflammatory disorders, medications that impact hemostasis (eg, NSAIDs, anticoagulants) and tumors. 1 Congestion of nasal blood vessels or irritation and drying of the nasal

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Acute Management of Massive Epistaxis After Nasotracheal Extubation
Kanta Kido DDS, PhD,
 Yuki Shindo DDS,
 Hitoshi Miyashita DDS, PhD,
 Mikio Kusama DDS, PhD,
 Shigekazu Sugino MD, PhD, and
 Eiji Masaki MD, PhD
Article Category: Case Report
Volume/Issue: Volume 66: Issue 4
Online Publication Date: Jan 01, 2019
DOI: 10.2344/anpr-66-02-09
Page Range: 211 – 217

Epistaxis is one of the most common complications of nasotracheal intubation. 1 – 3 Various methods have been developed to prevent or reduce bleeding, including thermosoftening of the nasal endotracheal tube as well as use of the gum elastic bougie technique. 4 – 6 However, management of massive epistaxis after nasotracheal extubation has not been well addressed, even in reviews of nasotracheal intubation for head and neck surgery. 1 , 3 Depending on the surgical procedure, epistaxis may be more complicated and difficult to control

A Case of Nasal Mucosa Cautery With Reintubation Under Pharyngeal Suction for Massive Epistaxis After Extubation
Yukiko Arai DDS, PhD,
 Akari Hasegawa DDS,
 Aki Kameda DDS,
 Saki Mitani DDS,
 Takuya Uchida DDS, PhD,
 Yasuhiko Kato DDS, PhD,
 Yozo Manabe DDS, PhD, and
 Yoshihiro Momota DDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 68: Issue 4
Online Publication Date: Dec 15, 2021
DOI: 10.2344/anpr-68-03-04
Page Range: 235 – 237

CASE REPORT A 27-year-old woman (height 156 cm, weight 47 kg, body mass index 19.3 kg/m 2 ) was scheduled for maxillary Le Fort I osteotomy and mandibular bilateral sagittal split osteotomies to correct maxillofacial deformities. She had a history of atopic dermatitis, allergic rhinitis, and retinal detachment; reported allergies to latex, walnuts, and ampicillin; and was taking bilastine daily. The patient denied any history of epistaxis, and preoperative nasal endoscopy showed no abnormal nasal cavity morphology or cysts. No abnormal

Figure.; Epistaxis Management Flowchart. Management of epistaxis in the primary dental care setting (adapted from National Institute for Health and Care Excellence15).
Ishfaq Khan
Figure.
Figure.

Epistaxis Management Flowchart.

Management of epistaxis in the primary dental care setting (adapted from National Institute for Health and Care Excellence15).

Figure 3 ; Anatomy of the blood supply to the nose and Foley catheter insertion of epistaxis.
Kanta Kido,
 Yuki Shindo,
 Hitoshi Miyashita,
 Mikio Kusama,
 Shigekazu Sugino, and
 Eiji Masaki
<bold>Figure 3</bold>
Figure 3

Anatomy of the blood supply to the nose and Foley catheter insertion of epistaxis.

Figure 2 ; Algorithm for the management of epistaxis. (From Mahmood S, Lowe T.8 Management of epistaxis in the oral and maxillofacial surgery setting: an update on current practice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:23–29.)
Kanta Kido,
 Yuki Shindo,
 Hitoshi Miyashita,
 Mikio Kusama,
 Shigekazu Sugino, and
 Eiji Masaki
<bold>Figure 2</bold>
Figure 2

Algorithm for the management of epistaxis. (From Mahmood S, Lowe T. 8 Management of epistaxis in the oral and maxillofacial surgery setting: an update on current practice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:23–29.)

Thermophysical Properties of Thermosoftening Nasotracheal Tubes
Yoshihiro Takasugi DDS, PhD,
 Koichi Futagawa MD, PhD,
 Takashi Umeda PhD,
 Kouhei Kazuhara ME, and
 Satoshi Morishita MS
Article Category: Research Article
Volume/Issue: Volume 65: Issue 2
Online Publication Date: Jan 01, 2018
DOI: 10.2344/anpr-65-02-06
Page Range: 100 – 105

Epistaxis has been reported as the most common complication of nasotracheal intubation. The incidence of epistaxis has been generally reported as ranging from 50 to 80%. 1 – 5 During nasotracheal intubation, the tip of the tube advances through the narrow nasal passages, reaches the posterior nasopharyngeal wall, and changes direction downward to the oropharynx. Epistaxis usually occurs from damage to Kiesselbach's plexus in Little's area in the anterior part of the nasal septum. 6 Although bruising of the mucosa overlying the turbinate

Use of a Modified Endotracheal Tube for Postoperative Intranasal Hemorrhage
Yasuhiko Sakata DDS,
 Saori Takagi DDS, PhD,
 Shinnosuke Ando DDS,
 Ryoko Kono DDS,
 Yuki Kiyohara DDS,
 Yuka Oono DDS, PhD, and
 Hikaru Kohase DDS, PhD
Article Category: Case Report
Volume/Issue: Volume 71: Issue 1
Online Publication Date: May 03, 2024
DOI: 10.2344/anpr-70-03-09
Page Range: 34 – 38

Orthognathic surgery or surgical/anesthetic procedures than induce substantial epistaxis postoperatively require swift, appropriate management to avoid potentially catastrophic complications. We report a patient in whom the use of a modified endotracheal tube (ETT) with a cuff as a transnasal airway and a choanal hemostasis balloon was effectively applied for emergent epistaxis control following orthognathic surgery. The patient provided written consent to publish the details of this case. CASE PRESENTATION The patient was a 27-year-old woman (height 165

Reducing Nasopharyngeal Trauma: The Urethral Catheter–Assisted Nasotracheal Intubation Technique
Allen Wong DDS,
 Paul Subar DDS, EdD,
 Heidi Witherell MD, and
 Konstantin J Ovodov MD
Article Category: Research Article
Volume/Issue: Volume 58: Issue 1
Online Publication Date: Jan 01, 2011
DOI: 10.2344/0003-3006-58.1.26
Page Range: 26 – 30

General anesthesia via endotracheal intubation for dental treatment may be performed from an oral or a nasal approach. 1 The obvious benefits of nasal intubation include improved working space in the oral cavity and the ability of the dentist to evaluate jaw relationships. Although it is generally safe, nasotracheal intubation is not without complications. The incidence of minor bruising to the mucosa overlying the inferior turbinates has been reported as high as 54%. 2 A search of the literature reveals epistaxis rates ranging from 18 to 66%. 3 – 8

Figure 1 ; Tamponade of the posterior nasal passage with a 14F Foley balloon catheter in case 2.
Kanta Kido,
 Yuki Shindo,
 Hitoshi Miyashita,
 Mikio Kusama,
 Shigekazu Sugino, and
 Eiji Masaki
<bold>Figure 1</bold>
Figure 1

Tamponade of the posterior nasal passage with a 14F Foley balloon catheter in case 2.

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