锦州医科大学耳鼻喉课件 Epistaxis.ppt

Epistaxis(nosebleed) Classification I. According to site Anterior Superior; Anterior ethmoid ( bleeding is from above ant. half of middle turbinate) Inferior; Greater palatine, Posterior; Sphenopalatine (Bleeding is from below anterior half of middle turbinate II. Primary secondary Ⅲ. According to Age Children: Foreign body, nose picking ,nasal diphtheria. Adults: Trauma, idiopathic. Middle age: tumors. Old age: hypertension. etiological factor of nose bleed 1 local cause: trauma inflammation tumor deviated nasal septum 2 systom reason Aetiology Local Causes Trauma Nose picking, Fractures (nasal bone, sinuses and/or skull base) Nasal intubation Surgery Infections ● Fungal infection ● Suppurative sinusitis ● Influenza, Measles,Diphtheria,Tuberculosis ● Atrophic rhinitis Local Causes Septum disorder (deviated nasal septum )- spur,perforation. Foreign body. . Local Causes Neoplasms of the nose, nasopharynx and sinuses General Causes Acute infectious disease - Influenza,measles,diphtheria,malaria, typhoid,et al. Cardiovascular disease - Hypertension, - Atherosclerosis, - Osler-Weber-Rendu disease Blood clotting problem - Haemophilia, purpura, leukemias, aregenerative anemia,et al. General Causes Vitamin C ,P K deficiencies. Severe liver kidney disease. Drugs – prescribed - Anticoagulants - Warfarin / Heparin. - Aspirin- platelet function inhibitor. Toxicosis Vicarious menstruation -during the period. Environmental reason High altitudes (drier and lower atm. pressure) Air-conditioning Extreme changes in temperature Idiopathic “Spontaneous” is a better description. Usually initiated by minor ‘digital’ trauma. Often associated with atmospheric drying. Blood supply of nasal cavity Vessels Involved Anterior ethmoid a. Posterior ethmoid a. Greater palatine a. Sphenopalatine a. Superior