Surgery is not the first-line treatment option for patients with epistaxis. Surgery is usually reserved for patients with either heavy active bleeding, recurrent epistaxis or non-compliant medical therapy.

Surgery is not the first-line treatment option for patients with epistaxis. Surgery is usually reserved for patients with either heavy active bleeding, recurrent epistaxis or non-compliant medical therapy.^{[1] [2]}

• Nasal cautery
  • Before cautery anesthesia bleeding site
  • Restrict nasal cautery to the site of bleeding
  • Nasal cautery is the most typical surgery procedure to stop nasal bleeding.
  • Surgical nasal cautery has two options :
    • Electrical cautery
    • Heat cautery
• Nasal balloon or Foley catheter:
  • A nasal balloon or Foley catheter is a good options to control bleeding specially in posterior-epistaxis.
• Embolization and surgical arterial ligation:
  • Embolization and surgical arterial ligation are the most effective procedures.
  • If these procedures do not stop bleeding, embolization of bleeding artery and surgical arterial ligation are the next best options.

• Surgery is not the first-line treatment option for patients with epistaxis. In active bleeding, nasal compression is the first line option to stop bleeding. If nasal compression and medical therapies not stop bleeding, surgery options are available to control bleeding.^[1]

• If these procedures do not stop bleeding, embolization of bleeding artery and surgical arterial ligation are the next best options.

• Endovascular embolization of the anterior and/or posterior ethmoid arteries is contraindicated, as they originate from the ophthalmic artery. Therefore, there is a risk of blindness with this procedure.^[1][3]

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