Abnormal vessels Whitish appearance immediately
which had caused epistaxis after topical TCA application
50% and 20% TCA solution are available for use in adult and children respectively. Beware the risk of septal perforation if the procedure performed bilaterally at the same time. Thus, application on the opposite site
be advised to be done once the earlier application site has healed.
Commercialized TCA stick are available for similar purpose.
Alternatively, bipolar cautery at low power setting can be done if this is available.
Watch video on Stopping Nose Bleeds by Nasal Cauterization @ YouTube
Watch video on Trichloroacetic Acid (TCA) Cautery for Epistaxis @ YouTube
Watch video on Stopping Anterior Epistaxis by Using Bioresorbable Nasal Dressing @ YouTube
These figures show a technique used to reduce the inferior turbinate size in refractory nasal obstruction caused by its hypertrophy. Radiofrequency Volumetric Reduction (RAVOR) uses radiofrequency waves delivered into the tissue by a double-prong tip. Instance reduction is seen during procedure. However, the actual effect is best assesed few weeks after the procedure performed. Symptomatic relief obtained without compromising the nasal epithelium with preservation of its mucociliary function. Similar bipolar radiofrequency diathermy technique is also available by a using longer single needle probe e.g Celon. Microdebrider submucosal turbinoplasty by using a specially designed probe is another minimally invasive
alternative with similar intent.
Disclaimer: The probe featured is from Sutter
and informations given are for educational purposes only.
Watch video on Turbinate Reduction: Surgeon's Perspective @ YouTube
Watch video on Radiofrequency Volumetric Reduction (RAVOR) for Inferior Turbinates Hypertrophy @ YouTube
Figure shows transillumination of frontal sinus by using light source emitted
by endoscope. The 'lightened" areas corresponds to the sites palpated
for tenderness in frontal sinusitis. In baloon sinuplasty, similar feature
being utilized for confirmation of entrance into its ostium. A darkened room
is preferred for better appreciation of this phenomena.