What are the treatment options for epistaxis (nosebleed) if nasal packing fails?

Updated: May 08, 2020
  • Author: Quoc A Nguyen, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Packing failure can be caused by inadequate placement resulting either from lack of patient cooperation (especially in the pediatric age group) or from anatomic factors (eg, deviated septum). In cases of packing failure, a careful endoscopic examination with the patient under general anesthesia may be considered. Bleeding sites can be cauterized under endoscopic guidance, a deviated septum can be straightened, spurs can be removed, and meticulous packing can be placed. [23]

If these steps fail to control the bleeding, arterial ligation (see below) may be performed at the same time.

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