Microwave ablation versus silver nitrate cautery for treating recurrent epistaxis in adolescents: A prospective, randomized case-control study

Int J Pediatr Otorhinolaryngol. 2019 Jun:121:41-45. doi: 10.1016/j.ijporl.2019.03.001. Epub 2019 Mar 4.

Abstract

Objective: To compare the outcomes of adolescent patients with recurrent anterior epistaxis (RAE) treated with either silver nitrate cauterization or microwave ablation (MWA).

Study design: and methods: In this prospective, randomized study, one hundred 13-18-year-old adolescents with RAE were assigned to two groups: the MWA group (n = 50) or the silver nitrate cauterization group (n = 50). Both groups were followed up for 12 months. The primary and secondary outcomes were evaluated.

Result: Ablation hemostasis was successfully achieved within 10-20 s in all patients in the MWA group. Eighteen (36.0%) patients in the silver nitrate group had recurrent epistaxis compared to three (6.0%) in the MWA group (P = 0.01) within 2-8 weeks after treatment. Two (2/48, 4.2%) patients in the MWA group had recurrent epistaxis compared to seventeen (17/43, 39.5%) in the silver nitrate group at 6 months; this difference was statistically significant (P = 0.01). However, 8 (8/37, 21.6%) patients in the MWA group had recurrent epistaxis compared to 15 (15/41,36.6%) in the silver nitrate group at 12 months; this difference was not statistically significant (P = 0.12). No treatment-related complications, including necrosis or septal perforation were seen in either group during follow up.

Conclusions: MWA may be a useful treatment for adolescents with RAE, as it had a lower incidence of recurrent epistaxis within 6 months of treatment compared to silver nitrate cauterization.

Keywords: Microwave ablation; Recurrent epistaxis; Silver nitrate cauterization.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Ablation Techniques*
  • Adolescent
  • Anti-Infective Agents, Local / therapeutic use*
  • Cautery*
  • Epistaxis / therapy*
  • Female
  • Humans
  • Male
  • Microwaves / therapeutic use*
  • Prospective Studies
  • Recurrence
  • Silver Nitrate / therapeutic use*

Substances

  • Anti-Infective Agents, Local
  • Silver Nitrate