Management of pediatric epistaxis in different age group in a tertiary care centre

Abstract

Background: Epistaxis is a common otorhinological emergency seen in children. Aetiology and treatment differ in different age group.Methods: A retrospective study conducted in a tertiary care hospital and data of pediatric patients (under 18 year) admitted with epistaxis were divided into three different age group. Group A (2 years to <5 years), group B (5 to <12 years) and group C (12 years to 18 years) and analysed.Results: Out of 216 total patients male outnumbered female in all age groups. Trauma including nose picking was most common cause in all the three age groups (54%, 45.4% and 31% respectively). 2nd most common cause noted was blood dyscrasia in group A (17.5%), idiopathic in group B (23.8%) and group C (22.5%). Tumours accounted for 11.3% of patients in group C. Observation alone (i.e. nasal mucosal hydration, use of topical decongestants, topical antibiotics) were the main intervention needed (70% in group A, 50% in group B and 28% in group C). Nasal packing and other methods were needed mainly in the older age groups. 61% of traumatic patients managed with observation alone whereas 55.8% of inflammatory group and 66.7% of blood dyscrasia group needed nasal packing for control of epistaxis.Conclusions: Trauma including nose picking is the most common cause of pediatric epistaxis among all age groups and usually managed well with observation alone. Nasal packing and other invasive treatment modalities are mostly needed in older age group of pediatric patients and those with non-traumatic causes of epistaxis.