• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권1호
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• pp.43-47
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• 2019

The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. The computed tomography scan revealed an "inhomogeneous solid lesion in the nasal fossa". With the patient under general anesthesia, the formation in the anterior portion of the right side of the nasal septum was removed up to its vascular base. Although electrical cauterization efficiently controlled the bleeding, we abraded the sub-perichondral area to prevent further bleeding as well as recurrence. The histological exam report confirmed the diagnosis of angiofibroma. As in our case, epistaxis is commonly the presenting sign of angiofibroma. Yet its onset was peculiar, given that the bleeding started with a low impact trauma. The nasal swelling was also a relevant feature as well as the breathing impairment. Although uncommon, nasal septal angiofibromas should considered in patients with epistaxis.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권4호
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• pp.223-231
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• 2020

Background: The most frequent complication of nasotracheal intubation (NTI) is epistaxis. Epinephrine nasal gauze packing has been used conventionally as a pre-treatment for reducing epistaxis, but it carries a disadvantage of pain and anxiety in patients. However, xylometazoline drops are easier to administer and more convenient for patients. We aimed at comparing the effectiveness of xylometazoline drops and epinephrine merocele packing in reducing bleeding and postoperative complications in our population. Methods: Our study enrolled 120 patients in a double-blind randomized controlled trial. We randomly allocated ASA1 or 2 adult patients into 2 groups: Group X and Group E. Group X received 0.1% xylometazoline nasal drops, and epinephrine (1:10,000) merocele nasal packing was used in Group E. The primary outcome was the incidence of bleeding during NTI; the severity of bleeding, navigability, bleeding during extubation, and postoperative complications were secondary outcomes. We used IBM SPSS and Minitab software for statistical analysis, and P < 0.05 was considered statistically significant. Results: We analyzed the data of 110 patients: 55 in Group X and 55 in Group E. The two groups did not have different bleeding incidence (56.4% vs 60.0%; P = 0.70); however, the incidence of severe bleeding was less with xylometazoline than with epinephrine (3.63% vs 14.54%; P < 0.05). We also observed less bleeding during extubation (38.2% vs 68.5%; P < 0.05) with xylometazoline. Other secondary outcomes were akin to both groups. Conclusion: The incidence of severe and post-extubation bleeding was significantly less with xylometazoline. Hence, it may be an effective alternative for reducing the incidence and severity of epistaxis during NTI.

• Tuberculosis and Respiratory Diseases
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• 제66권4호
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• pp.314-318
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• 2009

저자들은 반복적인 코출혈이 있는 가족에서 폐동정맥기형이 있는 동생과 점막의 모세혈관확장증을 가진 형을 경험하고 희귀한 유전질환인 유전출혈모세혈관확장증의 가계도를 확인하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한치과마취과학회지
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• 제13권2호
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• pp.51-54
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• 2013

A 30-year-old man with morbid obesity (height: 176 cm, body weight: 100 kg, body mass index: 32.28) was scheduled for reconstruction of the mandibular fracture. During induction of general anesthesia and nasotracheal intubation, we experienced massive epistaxis, hypoxemia and difficult airway management. Fortunately, we performed oro-tracheal intubation with direct laryngoscopy and it barely succeeded. He recovered without any residual complications and rescheduled seven days later and we successfully performed awake fiberoptic nasotracheal intubation. The patient discharged on the fourth postoperative day.

• 한방안이비인후피부과학회지
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• 제3권1호
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• pp.1-15
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• 1990

Aebaegeum has been widely used in the treatment of epistaxis, as based on Oriental Medical 1iteratures. In order to investigate experimentally the clinical effects of Aebaegeum, hemostatic time, plasma recalcification time and prothrombin time of hypoprothrombinemia induced by warfarin injection, action on isolated ileum, action on blood vessel, action on blood pressure and respiration and action on heart were observed. The result of the studies were obtained as follows: 1. Hemostatic time of vein ruptured mice was significantly shortened. 2. Plasma recalification time and prothrombin time of hypoprothrombinemic rats induced by warfarin injection were significantly shortened. 3. Spontaneous mobilities in the isolated ileum of mice were significantly suppressed, and contraction by acetylcholine chloride and barium chloride were inhibited. 4. Dilatation of blood vessel and downing of blood pressure of rabbit were noted. 5. Contraction of heart in the original position and isolated heart of frog were significantly shortened. According to the above result, it is expected that Aebaegeum can be widely applicable to the treatment of epistaxis.

• 한국임상수의학회지
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• 제12권1호
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• pp.853-860
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• 1995

Two cases of guttural pouch mycosis in race horses were observed for clinical and pathological aspects of the disease to investigate etiology and pathogenesis of dysphagia and epistaxis of the horse. In case 1 showing prolonged dysphagic sign a diphtheritic membrane was confined to the guttural pouch involved with neuritis of the glossopharyngeal nerve due to fungal penetration. The other horse showing fatal recurrent epistaxis had lesion of mycetoma invading the internal carotid artery to provoke erosion of the artery. An Aspergillosis sp. was isolated from the guttural pouches of the two horses and identified as A nidulans.

• 대한두개안면성형외과학회지
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• 제23권2호
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• pp.89-92
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• 2022

Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.332-336
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• 2001

This 18-year-old male patient had a massive epistaxis after motorcycle traffic accident on 1st day of admission. There were no other significant brain parenchymal lesion on initial brain CT exam, except multiple pneumocephalus and basal skull fracture lines. We treated epistaxis conservatively till vital signs were corrected, and then conventional cerebral angiogram was followed. On angiogram, there was traumatic pseudoaneurysm on C5 portion(by Fischer) of ICA, so we treated it only by endovascular stenting. For the purpose of sparing parent arterial patency, endovascular stenting on pseudoaneurysm may play a role with safety and good results.

• Clinical and Experimental Pediatrics
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• 제50권10호
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• pp.1018-1023
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• 2007

유전성 출혈성 모세혈관 확장증은 피부 점막 모세혈관확장증, 동정맥기형, 가족력을 3대 증상으로 하는 상염색체 우성 유전성 질환이다. 빈번한 코피가 가장 흔한 증상이며 폐, 뇌, 간 등에 동정맥기형이 동반될 수 있다. 저자들은 빈번한 코피, 폐와 뇌동정맥기형, 가족력을 가진 유전성 출혈성 모세혈관확장증 1례를 경험하고 이를 보고하는 바이다.

• 한국동물위생학회지
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• 제34권2호
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• pp.187-190
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• 2011

The Thoroughbred horse was an approximately 4-years-old castrated male with highly emaciation, nasal epistaxis and subsequently died. Gross necropsy revealed epistaxis and hyperemia on the lung, multiple hemorrhage in muscle, and liver was focally attached to the peritoneum with fibrin. According to polymerase chain reaction (PCR), Equine herpes virus type 1 and 4 (EHV type 1, 4) was detected in the lung and trachea. In bacterial culture from kidney, liver, spleen, muscle and blood, Streptococcus equi subsp. zooepidemicus was isolated. Based on the gross lesion and PCR, this horse was diagnosed as EHV type 1, 4 and S. zooepidemicus coinfection.