Nasal cautery

Introduction

Nasal cautery is a technique employed to assist with recurrent nose bleeds, also known as epistaxis.

Indications

The primary reason for nasal cautery is to help control recurrent or profuse epistaxis.

Risks

Like all procedures, Nasal cautery carries risks. These include:

  • Failure to stop epistaxis / Need for multiple procedures.
  • Nasal septal perforation.
  • Skin staining from Silver Nitrate (Temporary).
  • Nasal Adhesions.

Treatment Alternatives

There are some commercially available creams and ointments which may assist in some cases. All act to keep the nose moist and in some cases, they also contain substances which help constrict blood vessels.

General measure such as controlling blood pressure may also assist while some blood thinners and natural medicines may need review if they are contributing. Dr Morrissey can discuss the specific risk factors present in each situation and help address those issues.

Preoperative Instructions

Before surgery, it is important to discuss blood thinners with Dr Morrissey as they may need to be ceased prior to the surgery. If the case is to be completed under a local anaesthetic then no further preparation is needed.

Where a general anaesthetic is used you should adhere to the instructions provided by your Anaesthetist or the admitting hospital. Should you have any queries please contact the anaesthetist, admitting hospital or Dr Morrissey.

Procedure

Nasal cautery can be completed via a number of different methods. In some cases, it can be completed using local anaesthetic. In this case, Dr Morrissey uses either a topical chemical (Silver Nitrate) or a heated wire to address the affected vessel.

Under a general anaesthetic other techniques such as electrocautery and direct ligation of blood vessels are possible.

Each case is different, and Dr Morrissey can discuss the options most suitable for your circumstances.

Postoperative Instructions

Return to Normal Activities

Most adults and children recover quickly from nasal cautery. However, it is advisable to keep your child away from day-care, kindergarten and school for 1-2 days following surgery. Adults will usually be able to return to work 24-48 hours after cautery under general anaesthetic.

General activities can be resumed when you feel up to it. Please avoid vigorous nasal blowing, active sports, rough play and heavy lifting for 2 weeks.

Pain relief

People may experience some minor nasal discomfort following surgery.  Paracetamol (Panadol) or Ibuprofen (Nurofen) is usually all that is required. Please follow dosage instructions as advised by the manufacturer.

Should pain relief requirements exceed this, please contact Dr Morrissey.

Nose Care

Following the operation, there will often be some swelling within the nose, and it may be blocked. This may take up to 4 weeks to settle down.

Dr Morrissey advises the use of a nasal saline spray (FESS) at least twice a day to help keep the nasal lining moist and facilitate recovery. This practice should continue until review by Dr Morrissey.

Diet

There are no restrictions on diet.

Fever

It is common to have a mild fever for the first 24hrs after the operation.  Please call Dr Morrissey’s rooms if there is a persistent fever greater than 38.5°C.

Bleeding / Discharge

On rare occasions there may be a small amount of bleeding from the nose. Usually this will settle with simple pressure over a few minutes. Should bleeding be excessive or prolonged (>10min duration), please seek medical review via Dr Morrissey or your nearest Emergency Department.

Follow Up Appointment

An appointment is usually arranged when you book for surgery around 4 weeks after the procedure.

How to contact Dr Morrissey

For non-emergency issues please call (07) 4646 4275 for further instructions.

Dr Morrissey shares ‘on-call’ arrangements with other ENT surgeons and one is usually available to answer questions. After hours the "On Call" ENT surgeon can be contacted via the Toowoomba Base Hospital on (07) 4616 6000.

Should your concerns not be addressed via a phone call please present to your nearest Emergency Department.

In the event of an Emergency call 000 or attend the nearest Emergency Department.

Related Information

Nose Bleeds