జర్నల్ ఆఫ్ ఒటాలజీ & రైనాలజీ

Epistaxis at the Yaounde General Hospital, Cameroon: A study of 95 Cases

Andjock Nkouo Yves Christian*, Bola Siafa Antoine, Asmaou Bouba Dalil, Mindja Eko David, Dahda Line, Njock Richard, Ndjolo Alexis, Djomou Francois and Ngono Ateba Gladys

Background: Epistaxis is a frequent Ear, Nose and Throat (ENT) complaint that patients present to the emergency room or primary care in west countries. This pathology is sometimes linked to patients’ comorbidities (coagulopathies especially). Evolution is often benign. But in some cases, it can be life threatening. Few local data are available.

Objective: The general objective was to study epistaxis at the Yaounde General Hospital (YGH). Specifically: to determine the prevalence of epistaxis at YGH, to bring about the epidemiological, clinical, therapeutic and evolutionary profile of the study sample.

Material and methods: This was a transversal, descriptive and retrospective study. Conducted from January 2016 to December 2020, thus 5 years. During the study period, patients who presented at the ENT service of the YGH with complaints of epistaxis, active or dried up were included. Data analysis was done by version 23.0 of the Statistical Package for the Social Sciences (SPSS).

Results: We included 95 patients. Prevalence of epistaxis was 0.9%. Epidemiologically: Average ages mostly represented were between 10-20 years and 40-50 years respectively with 26.3% at 25.3%. Most patients were males, at 53.3%. Clinical and paraclinical layout: Risk factors were high blood pressure at 15.78 %, smoking at 7.36%, anticoagulant treatment 2.10%. 25.3% of patients presented with active epistaxis, and 74.7% of patients consulted with dried up epistaxis. Epistaxis was unilateral in 69.5% of cases. Epistaxis was anterior in 73.7 % of cases. Epistaxis was of mild abundance in 66.3% of cases, moderate abundance in 28.4% of cases and high abundance in 5.3%. Hemodynamically: 84.2% of patients had a normal blood pressure during consultation. 66.3% of patients had nasofibroscopy. Etiologies were: Fragile Kiesselbach’s plexus at 53.68%, essential causes at 29.47%, trauma at 10.52%, tumoral at 6.31%. 47 patients of the population sample carried out coagulation assessment, thus 49.5%. 22.1% of these patients had abnormal results with a prolonged prothrombin time. Regarding therapeutic and evolution: 22.1% of patients had treatment by chemical cauterization. 51.6% of patients received outpatient care. Evolution was favorable at 94%.

Conclusion: Epistaxis is a non-common patient presenting complaint at YGH, most patients are young adults of male sex. It is mostly unilateral and of mild abundance. Main etiology is a fragile Kiesselbach’s plexus. Treatment is anterior nasal packing, and evolution is favorable in our series.