A new double-lumen hemostatic device for treatment of intractable traumatic epistaxis induced by craniofacial basicranial fractures

Background and objective: Traumatic epistaxis is a complicated and sometimes life-threatening complication of skull-base fractures. The aim of the study was to observe the effect of a new hemostatic device on treatment of intractable traumatic epistaxis induced by craniofacial basicranial fractures. Methods: The study included 85 patients with intractable traumatic epistaxis induced by craniofacial basicranial fractures treated between January 2004 and December 2013 in our hospital. There were 58 males and 27 females between 18-66 years old with a mean age of (41.7±14.1) years and GCS score of (9.3±3.4) points (range, 3-15 points) on admission. The patients were treated with a new double-lumen hemostatic device together with a digital subtraction angiography (DSA) (Group A, 45 patients) or traditional anterior nasal packing with no use of DSA (Group B, 40 patients). The indices including hemostasis time, hemostasis success rate, infusion volume and hospitalization mortality were recorded and compared between the two groups. Results: In Group A, the success rate of hemostasis was 100%, with a mean hemostasis time of (13.1±2.9) min without obvious complications related to the operation or hemostatic device. Re-bleeding was found in 13 patients after the balloon deflation, all of whom were cured using an interventional therapy. The other 2 patients with negative DSA results were cured only with a prolonged compression time of the balloon. In Group B, the success rate of hemostasis was 62.5%, with a mean hemostasis time of (42.5±20.3) min, which was much longer than Group A (P<0.05). Group A had less blood transfusion with (600±244.9) ml and a lower hospital mortality (22.5%) compared with Group B (P<0.05). Conclusion: The new double-lumen hemostatic device combined with the DSA intervention is an effective treatment of traumatic epistaxis because of the shorter hemostasis time, higher hemostasis rate, lower blood transfusion volume and lower mortality rate compared with traditional anterior nasal packing.