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Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: five-year follow up of a randomised, controlled trial

  • S Robertson (a1) and H Kubba (a1)

Abstract

Objectives:

To determine the long-term outcome for children treated for recurrent epistaxis, and to compare the efficacy of antiseptic cream treatment and nasal cautery.

Study design and participants:

Retrospective analytical cohort study of 88 children treated for recurrent epistaxis in 2001.

Methods:

Five-year data on chlorhexidine–neomycin cream usage, nasal cautery, current epistaxis frequency and emergency room attendance was collected by telephone interview and case record review.

Results:

During their first clinic visit, 51 per cent of the children had been treated with cautery and cream and 35 per cent with cream alone; 14 per cent had received no treatment. Five years later, 65 per cent of these children were still having ongoing epistaxis. Those who had undergone cautery and received cream had the highest ongoing bleeding rate (77 per cent).

Conclusion:

The majority of children treated at our clinic for recurrent epistaxis had ongoing bleeding five years later. Despite the proven short-term efficacy of chlorhexidine–neomycin cream, few patients receive further courses of cream or are referred back to the clinic.

Copyright

Corresponding author

Address for correspondence: Mr Stuart Robertson, Specialist Registrar, Department of Paediatric Otolaryngology, Royal Hospital for Sick Children, Yorkhill, Dalnair Street, Glasgow G3 8SJ, Scotland, UK. Fax: 0141 201 0865 E-mail: stuart@glasgow.org

Footnotes

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Presented at the Otorhinolaryngological Research Society Meeting, 30 March 2007, Glasgow, Scotland, UK.

Poster presented at the American Society of Paediatric Otolaryngology Conference, 27–29 April 2007, San Diego, California, and at the American Academy of Otolaryngology Head and Neck Surgery Conference, 17–19 September 2007, Washington, USA.

Footnotes

References

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1 Petruson, B. Epistaxis in childhood. Rhinology 1979;17:8390
2 Guarisco, JL, Graham, HD. Epistaxis in children: causes, diagnosis, and treatment. Ear Nose Throat J 1989;68:522–38
3 Whymark, A, Crampsey, D, Fraser, L, Moore, C, Williams, C, Kubba, H. Childhood epistaxis and nasal colonisation with Staphyloccus aureus. Clin Otolaryngol 2007;32:230–1
4 Kubba, H, MacAndie, C, Botma, M, Robison, J, O'Donnell, M, Robertson, G et al. A prospective, single-blind, randomized controlled trial of antiseptic cream for recurrent epistaxis in childhood. Clin Otolaryngol 2001;26:465–8
5 Ruddy, J, Proops, DW, Pearman, K. Management of epistaxis in children. Int J Ped Otorhinolaryngol 1991;21:139–42
6 Murthy, P, Nilssen, ELK, Rao, S, McClymont, LG. A randomised clinical trial of antiseptic nasal carrier cream and silver nitrate cautery in the treatment of recurrent anterior epistaxis. Clin Otolaryngol 1999;24:228–31
7 Loughran, S, Spinou, E, Clement, WA, Cathcart, R, Kubba, H, Geddes, NK. A prospective, single-blind, randomised controlled trial of petroleum jelly/Vaseline for recurrent paediatric epistaxis. Clin Otolaryngol 2004;29:266–9

Keywords

Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: five-year follow up of a randomised, controlled trial

  • S Robertson (a1) and H Kubba (a1)

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