53058 - Posterior Nasal Haemorrhage Control

The need for arrest of posterior nasal haemorrhage with posterior nasal packing, with or without cauterization and anterior packing, arises when a patient experiences severe bleeding from the back of the nasal cavity—often from trauma, hypertension, or vascular anomalies—requiring urgent intervention under anesthesia to control the hemorrhage and stabilize the patient, excluding aftercare. This procedure is indicated for life-threatening posterior epistaxis, critical in the maxillofacial region where uncontrolled bleeding can obstruct the airway or lead to significant blood loss.

Specific conditions necessitating this intervention include:

• Traumatic epistaxis: A facial injury might rupture posterior nasal vessels, causing profuse bleeding that standard methods can’t stop, requiring packing to compress the source.
• Hypertension-related bleed: High blood pressure could weaken nasal arteries, leading to a posterior hemorrhage needing cauterization and packing to seal the vessel.
• Vascular anomalies: An abnormal vessel or tumour in the nasopharynx might bleed heavily, prompting urgent packing to tamponade the flow and stabilize the patient.
• Airway risk: Blood flowing into the throat could choke the patient, necessitating rapid control with posterior packing, often supplemented by anterior packing for added pressure.

For example, a patient with a sudden, heavy nosebleed after a fall might require posterior nasal packing under anesthesia to stop the bleeding from a deep vessel, with cauterization if a specific bleed point is identified. In an aged care setting, an elderly patient on blood thinners with uncontrolled posterior epistaxis could need this intervention to prevent airway compromise or hypovolemic shock, tailored to their frailty and higher bleeding risk. By packing the nasal cavity—sometimes with additional cauterization—this service halts severe bleeding, protects the airway, and stabilizes the patient, making it an essential emergency procedure within the maxillofacial framework.

Stops severe nasal bleeding, protects airway, and stabilizes patient condition.

Recovery of 1-2 days with nasal packing discomfort and monitoring; hospital stay typically required.