Nosebleeds are one of the most common complaints in the ENT field.
Almost everyone has experienced a nosebleed at least once in their life. Although it is usually due to simple reasons and
can be easily stopped, sometimes the cause is very serious and life-threatening bleeding may occur.
Why Does the Nose Bleed Often?
The inside of the nose is quite severe. It contains dense and superficial vessels. Especially the front
part of the partition that divides the nasal cavity into two is a part where the vessels coming to the nose meet each other and these vessels are quite superficial. Especially in children, this part may bleed even without any effect. The meats called turbinates located on both sides of the nasal cavity
are very rich in vessels and are the cause of some bleeding.
What are the Causes of Nose Bleeding?
Nose bleeding can be caused by both nasal causes (local causes). It also develops due to problems outside the nose (general
reasons).
Local Causes:
- Inflammations inside the nose
- Sinusitis
- Blows to the nose
- Children's nose picking
- Foreign objects inserted into the nose
- Intranasal and sinus tumors
- Bone curvature in the nose (septum deviation)
- Allergic rhinitis
General Causes:
- Hypertension
- Blood Diseases (Bleeding- clotting disorders, leukemia, etc.)
- Intestinal Parasites
Which Tests Should Be Performed?
Especially in severe nosebleeds, the first thing that is usually done is to stop the bleeding
regardless of the cause. . After the bleeding is stopped, some research should be done on the cause.
The first thing to do to investigate the cause is to examine the patient. With multiple examinations
the reason can be understood. Tests that can be performed depending on the suspected cause are as follows
- Blood pressure measurement
- Taking sinusitis films (normal films or tomography)
- Investigation for intestinal parasites
- Bleeding, Coagulation tests, Tests related to blood diseases. These tests are not always applied to every patient
. Depending on the reason the doctor suspects, some of them are done to try to find the cause.
How is it treated?
Many nosebleeds occur spontaneously. It stops with bleeding or when the patient holds the tip of the nose and applies cold.
However, bleeding that does not stop in this way requires medical intervention. Interventions that can be done to stop bleeding
are as follows:
- Burning of the Vein: It is used for mild and frequently recurring bleeding. It is attempted to prevent bleeding by applying chemical substances to the vascular network in the front
part of the nasal compartment. There is a risk of perforation of the nasal compartment when applied to both sides
or when excessive chemicals are applied.
-Placing a tampon: It is a frequently applied treatment method. It is used in bleeding that cannot be stopped by holding the tip of the nose or applying cold
. The tampon placed in the nasal cavity stops bleeding by putting pressure on the bleeding vein. While gauze
with antibiotic creams applied can be used as a tampon, more comfortable
tampons with a tube in the middle that will allow the patient to breathe can also be used. Tampons are usually removed after 48 hours. Leaving it for a longer period of time may sometimes lead to
problem infections. Giving antibiotics to the patient during the tampon period should not be neglected.
Sometimes the source of nose bleeding is the back of the nose and cannot be stopped with tampons placed from the front.
In this case, the tampon called the posterior tampon, which is inserted through the mouth and placed in the back of the nose. It is used.
- Ligation of the Vessels: This procedure is a surgery and is used in bleeding that is severe enough to threaten the patient's life and does not stop with the insertion of a tampon. The vessel, determined according to the location of the bleeding, is sometimes tied through the sinus or sometimes by opening the neck. During the interventions performed on the patient, it is important to make the patient
comfortable. Especially in elderly and hypertensive patients, diazem
or other sedative medications may need to be given to the patient for this purpose.
What Can I Do at Home When My Nose Bleeds?
Many times, the patient's own methods can stop the bleeding. The first thing the patient should do is to hold the tip of the nose tightly and lean the head forward. If the head is tilted back, the chance of blood flowing from the nasal
throat increases. Applying cold on the nose is also beneficial. The patient may even use a gauze to act as a buffer to the front of the nose
He can also put a cloth. However, even if the patient's own methods
stop the bleeding, he/she must be examined by an ENT specialist at the appropriate time.
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