Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: Jan 01, 2019

Acute Management of Massive Epistaxis After Nasotracheal Extubation

DDS, PhD,
DDS,
DDS, PhD,
DDS, PhD,
MD, PhD, and
MD, PhD
Page Range: 211 – 217
DOI: 10.2344/anpr-66-02-09
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Epistaxis is one of the most common complications of nasotracheal intubation and can be life-threatening. However, there is little discussion in the current literature on the acute management of massive epistaxis after nasotracheal extubation. This is a report of 2 patients who experienced severe unanticipated nasal bleeding immediately after extubation, 1 after a surgical procedure for oral cancer and another after restorative dental treatment. In both cases the significant epistaxis was managed successfully with a Foley balloon catheter used to pack the posterior nasal cavity. The Foley catheter technique may be useful for managing and arresting sudden postextubation epistaxis.

Keywords: Epistaxis; Nasotracheal extubation; Foley catheter
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Copyright: © 2019 by the American Dental Society of Anesthesiology
<bold>Figure 1</bold>
Figure 1

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

<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.)

<bold>Figure 3</bold>
Figure 3

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

Contributor Notes

Address correspondence to Dr Kanta Kido, Department of Dental Anesthesiology and Pain Management, Tohoku University Hospital, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan; kido@me.com.
Received: Sep 18, 2018
Accepted: Feb 28, 2019