What is it?
Epistaxis is the loss of blood from the tissue lining the inside of the nasal cavities. It is primarily classified into anterior (the most frequent and less serious type, where blood flows out through the nostrils) and posterior (less common, but more intense and typically requiring medical attention).
Causes
Nosebleeds occur when blood vessels in the nasal mucosa rupture. The most common causes include:
- Cold weather, dry air, and heating systems that dry out the airways.
- Picking the nose forcefully, blowing the nose too hard, or sustaining an impact.
- Allergies or exposure to irritating chemical substances.
- High blood pressure (hypertension), blood clotting disorders, or the excessive use of anticoagulant medications and decongestants.
Síntomas
- Blood discharge, ranging from a light drip to a heavy flow.
- Presence of blood clots.
- A sensation of fluid trickling down the back of the throat.
How do we treat it?
When episodes are mild, first-aid measures may be sufficient. However, if the bleeding does not stop with basic interventions, or if it results from a severe blow, it is essential that an otolaryngologist (ENT specialist) performs nasal packing or cauterization. There are several techniques available for this, and your specialist will determine the most appropriate approach based on your specific case:
- Endoscopic arterial ligation
A procedure performed using a camera (endoscope) inserted through the nasal cavity, allowing the surgeon to locate and close—or cauterize—the main arteries that supply blood to the nose (such as the sphenopalatine artery), thereby cutting off the blood flow.
- Nasal cauterization
This can be performed using chemical agents (such as silver nitrate) or via electrical energy/laser. It is used to seal specific, visible bleeding points, typically located on the anterior (front) part of the nasal septum.
In extremely complex cases, other procedures—such as embolization or the ligation of the maxillary or external carotid artery—may also be performed.