Treatment options for epistaxis
| Modality | Data from RCTs | Data from case reports/uncontrolled series |
|---|---|---|
| RCTs, randomised controlled trials. | ||
| Local ablation | ||
| Laser: argon, Nd-YAG | None | Short term success in expert hands25,26 |
| Cauterisation | Not recommended due to local tissue damage | |
| Surgery | ||
| Septal dermatoplasty | None | May be beneficial27 |
| Septal closure | None | Beneficial if tolerated28 |
| Arterial ligation | None | Case reports only, long term effects unknown |
| Embolisation | None | Anecdotal only : short term benefits (?<1 year) |
| Systemic therapy | ||
| Oestrogen-progesterone | Beneficial in heavily transfusion-dependent patients | |
| Tranexamic acid and antifibrinolytics | None | Short term benefit and risks unknown (see debate) |
| Topical therapy | ||
| Nasal sprays and creams | None | |