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Dr Sari Wulan, SpTHT-KL

Department of Otorhinolaryngology - Head &

Neck Surgery!dayana !ni"er#ity $aculty of %edicine,

Sanglah eneral Ho#pital Denpa#ar

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'pi#ta(i#) from the reek *ord) epi +on #tao +to

fall in drop → .leeding from the no#e

Se"erity of epi#ta(i#) %ild, anterior .leeding that re#ol"e#

#pontaneou#ly Se"ere, po#terior .leeding *ith hypoten#ion,

anemia and air*ay compromi#e that lead todeath

 

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'tiology)

Local)o Trauma) digital, fracture

o Na#al #pray

o /nflammatory reaction

o 0natomic deformitie#o $oreign .odie#

o /ntrana#al tumor#

o 1hemical inhalant#o Surgery

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Sy#temic)

o 2a#cular di#order#o 3lood cell anomalie#o 3lood cell malignancie#o 0llergie#o %alnutritiono 0lcoholo Hyperten#ion

o Drug#o /nfection

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0nterior .leeding) .leeding from anterior part of#eptum +Little4# area and anterior ethmoidartery

  Little area5 Kie#ell.ach ple(u# mo#t fre6uent

area of .leeding

7o#terior .leeding) .leeding from po#teriorethmoid artery, #phenopalatine artery

3leeding commonly #e"ere

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%anagement)

Stop the .leeding8 identified .leeding point aftercleaning the na#al ca"ity

  put lidocain & adrenalin gaue for 9 - :; minute# in

na#al ca"ityo When the .leeding #top, .leeding point

cauteriation .y 0gNO< =;-, tri chlor aceticacid :;> or electrocautery

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o When .leeding #till profu#e →packing na#alca"ity *ith ri..on gaue for = day#

o When .leeding #till occur, packing *ith po#teriorpacking + 3ello6

o When .leeding #till occur, ligation of arteryartery) - anterior ethmoidal artery  - po#terior ethmoidal artery  - internal ma(illary artery

  - #phenopalatine artery  - e(ternal carotid artery

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7re"ention of complication  1omplication can occur)

  - direct from .leeding) #hock

  treatment) intra "enou# fluid drip ortran#fu#ion

  - effect of gaue packing) infection) middle

ear infection, #inu#iti#

  treatment) oral anti.iotic

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7re"ention for relap#e

  'pi#ta(i# only #ymptom, importance to detectcau#e of epi#ta(i#

  /f the di#ea#e treata.le, epi#ta(i# can notrelap#e

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