Comparison of two coagulation techniques for the control of pediatric recurrent anterior epistaxis with allergic rhinitis: Semi-randomized clinical trial

Abstract

Objective

To compare the long-term outcomes, postoperative pain, and complications of bipolar electrocautery (BEC) and radiofrequency coagulation (RFC) in the treatment of pediatric patients with recurrent anterior epistaxis (RAE) and allergic rhinitis (AR).

Materials and methods

Children presenting with RAE and AR were prospectively semi-randomized to receive BEC or RFC during the 2-year period. We recorded the occurrence of recurrent epistaxis as well as epistaxis severity scores (ESSs) and visual analogue scale (VAS) scores for AR-related symptoms.

Results

In total, 67 children were included: 34 in the BEC group and 33 in the RFC group. The recurrent epistaxis rate was significantly higher in the BEC group than in the RFC group at 4 weeks (17.6 % vs. 3.0 %) and at 6 months (11.8 % vs. 0.0 %); there were no significant differences at 12 months (8.8 % vs. 0.0 %). The RFC group had lower mean ESS scores at all time points. Mean VAS scores for runny nose or itchy nose showed better improvement in the RFC group. Mean VAS scores for postoperative pain were significantly lower in the RFC group at postoperative 4 weeks, as was the occurrence of nasal crusting. During the follow-up period, septal ulceration was seen in three patients at postoperative 6 months and septal perforation was observed in two patients at 12 months in the BEC group, whereas no septal necrosis or septal perforation occurred in the RFC group.

Conclusions

Both methods were effective for treating pediatric patients with RAE and AR. However, RFC was associated with a lower incidence of recurrent epistaxis, less crusting, lower postoperative pain, and fewer complications, implying that it may be the superior treatment.