Keywords
Treatment
Clinical
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To review the literature on the treatment of epistaxis, or nosebleeds. Bibliographic review: The Tranexamic Acid (TXA), which proved to be effective in different contexts, including patients using antiplatelet drugs. TXA was superior to other interventions, providing faster hemostasis, lower recurrence rate, and greater patient satisfaction. Oral, intranasal and topical administration of TXA has demonstrated its versatility. Furthermore, intranasal topical application of TXA was effective, reducing the need for nasal packing and rebleeding within 24 hours. Results: Comparative studies have confirmed the superiority of TXA over adrenaline, tetracycline, and anterior nasal packing in the treatment of epistaxis. However, it is necessary to consider methodological differences between studies and expand research to confirm and extend its benefits.
References
ATTIA TM. Efficacy and Safety of Daflon in the Treatment of Idiopathic Epistaxis. Am J Rhinol Allergy, 2019; 33(1): 62-68.
GRENCHESKI, et al. Bleeding frequency during physiotherapy in thrombocytopenic patients undergoing hematopoietic stem cell transplantation. PLoS One. 2021; 16(7): 0255413.
HAJIMAGHSOUDI M e LARGANI HA, et al. A novel method for epistaxis management: Randomized clinical trial comparing nose clip with manual compression. Am J Emerg Med. 2018; 36(1): 149-150
HOSSEINIALHASHEMI M, et al. Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial. Ann Emerg Med. 2022; 80(3): 182-188.
KHANWALKAR AR, et al. Randomized, controlled, double-blinded clinical trial of effect of bevacizumab injection in management of epistaxis in hereditary hemorrhagic telangiectasia patients undergoing surgical cauterization. Int Forum Allergy Rhinol. 2022; 12(8): 1034-1042.
KOÇAK HE, et al. Comparison of topical treatment methods used in recurrent anterior epistaxis: a randomized clinical trial. Braz J Otorhinolaryngol. 2021; 87(2): 132-136.
KROON SH, et al. Oral itraconazole for epistaxis in hereditary hemorrhagic telangiectasia: a proof-of-concept study. Angiogenesis. 2021; 24(2): 379-386.
KRULEWITZ NA e FIX ML. Epistaxis. Emerg Med Clin North Am. 2019; 37(1): 29-39.
LEE JM, WU V e FAUGHNAN ME, et al. Prospective pilot study of Floseal® for the treatment of anterior epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). J Otolaryngol Head Neck Surg. 2019; 1548(1): 48.
LOU Z e WEI H. Identification of bleeding sites and microwave thermal ablation of posterior epistaxis. Acta Otolaryngol. 2019; 139(1): 70-74.
MACDONALD S, et al. Characterization of a large cohort of patients with unclassified bleeding disorder; clinical features, management of haemostatic challenges and use of global haemostatic assessment with proposed recommendations for diagnosis and treatment. Int J Lab Hematol. 2020; 42(2): 116-125.
MCWILLIAMS JP, et al. North American Study for the Treatment of Recurrent Epistaxis with Doxycycline: The NOSTRIL trial. J Thromb Haemost. 2022; 20(5): 1115-1125.
MURRAY MH, et al. Management of Persistent Epistaxis Using Floseal Hemostatic Matrix vs. traditional nasal packing: a prospective randomized control trial. J Otolaryngol Head Neck Surg. 2018; 47(1): 3.
PETERSON LK et al. Efficacy of Timolol in a Novel Intranasal Thermosensitive Gel for Hereditary Hemorrhagic Telangiectasia-Associated Epistaxis: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2020; 146(11): 1006-1014.
REUBEN A, et al. The Use of Tranexamic Acid to Reduce the Need for Nasal Packing in Epistaxis (NoPAC): Randomized Controlled Trial. Ann Emerg Med. 2021; 77(6): 631-640.
SOSUAN GMN, et al. A randomized controlled trial on the effects of oxymetazoline nasal spray after dacryocystorhinostomy among adult patients. BMC Res Notes. 2020; 13(1): 236.
TEO WY, et al. Outcome of childhood epistaxis with treatment of allergic rhinitis: a randomized controlled study. Eur J Pediatr. 2023; 182(3): 1127-1135.
WOMACK JP, et al. Epistaxis: Outpatient Management. Am Fam Physician. 2018; 98(4): 240-245.
ZAHED R, et al. Topical Tranexamic Acid Compared with Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized Controlled Trial. Acad Emerg Med. 2018; 25(3): 261-266.