• Richard Douglas and Peter-John Wormald.
• Department of Surgery, University of Auckland, Auckland, New Zealand.
• Curr Opin Otolaryngol Head Neck Surg. 2007 Jun 1; 15 (3): 180-3.

Purpose Of ReviewThe treatment of epistaxis has undergone significant changes in recent years. Gone are the days when patients had an uncomfortable posterior nasal pack inserted then spent several days on the ward only to bleed again on its removal. New packing devices, ingenious haemostatic agents and endoscopic surgical approaches have been developed to provide a variety of effective and well-tolerated treatment options. This paper will discuss the evolution and utility of these devices and techniques for managing difficult epistaxis patients.Recent FindingsModern packing devices are much easier to insert than traditional gauze packs and are no less effective. A major advance in the management of posterior epistaxis has been the development of the technique of endoscopic ligation.SummaryAnterior epistaxis is generally easy to control with local cautery. The optimal management of posterior epistaxis is to insert a pack to control the bleeding before taking the patient to the operating theatre to ligate the sphenopalatine artery endoscopically.

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