Abstract | OBJECTIVES/HYPOTHESIS: To evaluate the effectiveness of gelatin- thrombin matrix for first line treatment of posterior epistaxis. Secondarily, we evaluated discomfort during treatment and the cost savings of treatment with gelatin- thrombin matrix compared to posterior packing, endoscopic, or endovascular treatment at our institution. STUDY DESIGN: Prospective pilot, nonblinded, noncontrolled registered clinical trial (NCT01098578). METHODS: Twenty patients with posterior epistaxis were enrolled into this study. Gelatin- thrombin matrix was used for posterior epistaxis treatment with simultaneous ipsilateral choanal occlusion. Patients were discharged within 2 hours of being successfully treated. A visual analog scale (range 0-10) was used to assess treatment discomfort. Patients were evaluated in clinic 5 and 30 days after treatment to assess for intranasal complications and recurrent epistaxis. RESULTS:
Gelatin- thrombin matrix successfully treated epistaxis in 80% of the patients. The procedure was associated with a mean discomfort of 3.6 (range 0-9.7). The institutional per case cost of treatment of patients with posterior epistaxis with gelatin- thrombin matrix is 80.3%, 87.4%, and 89.4% less than with endoscopic surgery, posterior packing, or embolization, respectively. There were no complications. CONCLUSION: This pilot study demonstrated that gelatin- thrombin matrix is a safe and both a clinically effective and cost-saving means of treating posterior epistaxis. In this study, its use is associated with a low level of discomfort. This treatment method may improve the quality of care for patients with posterior epistaxis.
|
Authors | Shaun J Kilty, Mohammad Al-Hajry, Dakheelallah Al-Mutairi, James P Bonaparte, Melanie Duval, Euna Hwang, Darren Tse |
Journal | The Laryngoscope
(Laryngoscope)
Vol. 124
Issue 1
Pg. 38-42
(Jan 2014)
ISSN: 1531-4995 [Electronic] United States |
PMID | 23754469
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | © 2013 The American Laryngological, Rhinological and Otological Society, Inc. |
Chemical References |
- Hemostatics
- Gelatin
- Thrombin
|
Topics |
- Adult
- Aged
- Aged, 80 and over
- Endoscopy
- Endovascular Procedures
- Epistaxis
(therapy)
- Female
- Gelatin
(therapeutic use)
- Hemostatics
(therapeutic use)
- Humans
- Male
- Middle Aged
- Pilot Projects
- Prospective Studies
- Thrombin
(therapeutic use)
|