Endoscopic surgery can control persistent or recurrent nosebleeds when simpler treatments are not enough.
For information about common causes and first-aid treatment, see Nosebleeds.
When is surgery considered?
Most nosebleeds do not require surgery. Surgery may be considered when bleeding is severe, recurrent, comes from a deeper part of the nose, or continues despite treatments such as cautery or nasal packing.
What surgery is performed?
Surgery is usually performed through the nostrils using a nasal endoscope.
The surgeon locates the likely source of bleeding and controls the responsible blood vessel using cautery, clips, or other techniques.
For persistent or posterior nosebleeds, this often involves controlling branches of the sphenopalatine artery, one of the main arteries supplying the back of the nasal cavity.
If the bleeding comes from another area, treatment is directed to the vessel responsible.
What happens after surgery?
Some congestion, crusting, or minor blood-stained drainage is expected during early healing. Saline rinses or other nasal care may be recommended depending on the procedure.
Surgery controls many difficult nosebleeds, but bleeding can sometimes return.
Are there alternatives to surgery?
In selected cases, arterial embolization may be performed by an interventional radiology team.
During embolization, a small catheter is passed through the blood vessels and the vessel contributing to the bleeding is blocked.
The choice between surgery and embolization depends on the source of bleeding, previous treatments, medical condition, and individual anatomy.
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