Nosebleeds are a common problem for
which patients get seen by an ear nose and throat doctor. In this particular
patient, she has been having recurrent nosebleeds several times a week for the
past few months. The nose is carefully examined to find a source of the
nosebleed. In some patients, there is a vascular knuckle that can erupt causing
a spurting type of nosebleed and in others, there are superficial blood vessels that
can lead to an oozing or drippy type of nosebleed. Before cauterization, the nose
is anesthetized using a cotton ball soaked with lidocaine.
After a short period of time, cauterization can commence. The most common type of cauterization is
using a silver nitrate stick. When applied to the nasal surface, nitric acid
is formed causing a chemical burn turning the area brownish white. However in certain situations when the
blood vessel is large, a much deeper cauterization is required using
electricity. Bipolar cauterization is shown here
whereby an electric current is passed between the metal prongs burning the
tissue not only at the surface, but underneath
as well. It takes about two weeks for the area to completely heal.