I have suffered from nosebleeds for most of my 39 years. They occur usually
during dry weather and when I have a cold or sneezing attack. Once I have a
nosebleed they tend to occur frequently, sometimes spontaneously. I have
heard about cauterization as a cure. I'm curious about several aspects:
1. Ballpark costs, as I have no health coverage.
2. Possible side effects.
3. Time to heal after procedure.
4. Any advice or warnings?
Thanks.
Reply -------------------------------
I don't usually recommend nasal cautery as an intial treatment for the type of nose bleeding you describe. Nasal cautery is most commonly used in the treatment of an active nose bleed that will not stop spontaneously or with simple pressure. Recurrent nose bleeding such as you describe is most often related to a variety of factors most notably dryness of the membranes inside the nose. Frequent rubbing or "picking" of the nose is also a common associated factor. People who are taking aspirin, certain arthritis medications, or anticoagulants such as coumadin are prone to frequent nose bleeding.
The most important initial steps in the management of nose bleeding such as you describe is proper moisturization of the nasal lining and avoidance of direct manipulation of the nose. I highly recommend the regular usage of nasal saline sprays or nasal saline gels which are available over-the-counter - common brand names include Ocean Nasal Spray, Ayr spray or gel, Sea Mist, etc. These sprays are safe to use regulary and frequently. I prefer the direct application of nasal saline gel (Ayr saline gel) several times daily. The use of humidification in the home during dry seasons is also helpful.
If after several weeks of regular adherence to these measures fails to reduce the frequency of the nosebleeding, then nasal cautery might be considered. Simple nasal cautery can be accomplished with a chemical known as silver nitrate and can be performed during an office visit to a physician. Occasionally electrical cautery will be recommended which is typically done by an otolaryngologist and requires local anesthesia, but can also be done as an office procedure. Costs vary regionally, but I would guess they would range anywhere from $50-$100 dollars for chemical cautery to as much as a couple hundred dollars for electrical cautery procedures. Potential side effects include the formation of a hole through the nasal septum which can cause further problems with bleeding due to crusting common with septal perforations, however this is an unlikely complication of an isolated nasal cautery and would be more commonly associated with the need for frequent nasal cautery.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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