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Nasal packing is typically categorized into anterior nasal packing and posterior nasal packing. [22] Nasal packing may also be categorized into dissolvable and non-dissolvable types. Dissolvable nasal packing materials stop bleeding through use of thrombotic agents that promote blood clots, such as surgicel and gelfoam. [4]
A nosebleed (epistaxis) usually occurs in the anterior part of the nose from an area known as Kiesselbach's plexus which consists of arteries. Woodruff's plexus is a venous plexus in the posterior part and a nosebleed here accounts for only between 5 and 10 per cent of nosebleeds. Older adults are most often affected. [5]
•Thudichum's nasal speculum-do-; short blades ( uses: anterior rhinoscopy - to see the Little's area, ant-inferior part of nasal septum, anterior part of inferior and middle turbinate and meatus, as well as any pathological lesion in the area; also used in certain nasal operations ) •St. Clair Thompson's long bladed nasal speculum
The sinus communicates through an opening into the semilunar hiatus on the lateral nasal wall. [citation needed] The medial wall is composed primarily of cartilage. [1] [3] On the posterior wall are the alveolar canals, transmitting the posterior superior alveolar vessels and nerves to the molar teeth. [citation needed]
The sphenopalatine artery is the artery commonly responsible for epistaxis (difficult to control bleeding of the nasal cavity, especially the posterior nasal cavity). [3] In severe nose bleed cases which do not stop after intense packing of anti-clotting agents, the sphenopalatine artery can be ligated (clipped and then cut) during open surgery ...
Patient lies down for 10–15 minutes after operation and pack is removed after an hour. Antibiotic should be given for 5–6 days in cases of suppuration depending upon culture and sensitivity. [17] Oral and local decongestant are given to improve the patency of ostium. [18] Analgesics may be required for post-operative headache. [9]
Kiesselbach's plexus is an anastomotic arterial network (plexus) of four or five arteries in the nose supplying the nasal septum. It lies in the anterior inferior part of the septum known as Little's area, Kiesselbach's area, or Kiesselbach's triangle. It is a common site for anterior nosebleeds.
The anterior nares can act as a colonizing point from which the infection can spread. [2] This can be particularly troublesome if the strain is an antibiotic-resistant (commonly MRSA or ORSA) strain. MRSA (first discovered in the UK in 1961) has become particularly widespread in hospitals and is commonly considered a super bug.
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