Management of profuse epistaxis in post-irradiated nasopharyngeal carcinoma patients: 10-year experience in a tertiary centre

Abstract

Objective: To review the management of profuse epistaxis in post-irradiated nasopharyngeal carcinoma (NPC) patients, and to identify any clinical predictors of pseudoaneurysm as the cause of epistaxis in this group of patients.

Methods: Retrospective review of clinical records and radiological investigations of the post-irradiated NPC patients, who presented with profuse epistaxis and underwent angiogram, in Queen Mary Hospital from January 2002 to December 2011.

Results: 50 post-irradiated NPC patients with profuse epistaxis were included, among which, 24 were diagnosed to have pseudoaneurysm of internal carotid artery (ICA), and 26 patients with bleeding due to other causes. No suitable parameters, including systolic or diastolic blood pressure, heart rate or haemoglobin level, were found to be a useful predictor of pseudoaneurysm as the cause of bleeding.

Conclusion: Angiogram is necessary to rule out pseudoaneurysm bleeding, in the management of profuse epistaxis in post-irradiated nasopharyngeal carcinoma patients.