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Typically, dissolvable nasal packing is first attempted; if the bleeding persists, non-dissolvable nasal packing is the next option. Traditionally, nasal packing was accomplished by packing gauze into the nose, thereby placing pressure on the vessels in the nose and stopping the bleeding.
Bleeding within the confines of the mucoperichnondrium leads to a septal hematoma, where as external bleeding from Kiesselbach's plexus results in epistaxis. [3] The Kiesselbach plexus is located anterior inferior of the nasal septum, where the anastomosis of blood vessels is located.
Following nasal surgery or frequent nosebleeds, gauze or cotton may be inserted into the nose to stop the bleeding. This process is called therapeutic nasal packing. Nasal packing sometimes causes blood to back up into the middle ear, causing hemotympanum. Removing the packing may allow the blood to drain from the ear.
•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
Severe bleeding occurs as the result of facial trauma in 1–11% of patients, and the origin of this bleeding can be difficult to locate. [11] Nasal packing can be used to control nose bleeds and hematomas that may form on the septum between the nostrils. [2] Such hematomas need to be drained. [2]
An internal bleeding require to call to emergency medical services. In the event of bleeding caused by an external source (trauma, penetrating wound), the patient is usually inclined to the injured side, so that the 'good' side can continue to function properly, without interference from the blood inside the body cavity. [citation needed]
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Packing of nasal cavity and sinus is sometime required. Suturing of buccal incision is recommended with absorbable suture material. The patient should be advised against overenthusiastic blowing of the nose for at least a week. [3]
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