Epistaxis (thesaurus synonyms: epipharyngeal hemorrhage; epipharyngeal hemorrhage; epistaxis; multiple epistaxis; nosebleed; nasal hemorrhage; postnasal hemorrhage; postnasal hemorrhage; rhinorrhagia; ICD-10-GM R04.0: epistaxis) refers to nosebleed.
Nosebleeds can be a symptom of many diseases (see under “Differential diagnoses”).
Usually, bleeding occurs from the vessels of the nasal mucosa, primarily from the Locus Kiesselbachii (approximately 90%). The Locus Kiesselbachii is a vascular plexus in the anterior portion of the nasal septum (nasal septum). Its superficial location under a thin mucosa predisposes to injury and rupture. In many cases no cause can be found out, then it is called idiopathic/habitual/essential epistaxis.
A further distinction is made between local and symptomatic nosebleeds.
Sex ratio: boys to girls 2:1. males and females are equally affected.
Frequency peak: Epistaxis can occur at any age. It frequently occurs in very young and very old patients.
The prevalence (disease incidence), in this case lifetime prevalence, is approximately 60%. It is estimated that approximately 10% of adults have experienced nosebleeds.
The incidence (frequency of new cases) is 121 cases per 100,000 inhabitants per year in Germany in an emergency department in Eastern Thuringia.
Course and prognosis: In the majority of cases nosebleeds are not dangerous and stop spontaneously after a few minutes. In more than 80 %, a local vascular injury of the anterior nasal septum (nasal septum) is the cause of the nosebleed. In 65 to 75 percent of cases, the bleeding can be stopped with simple measures (see “Further therapy” below). Basic measures such as compression of the nostrils, application of a cold compress to the forehead or neck, or nasal sprays containing oxymetazoline help in most cases. Only a small proportion of sufferers (6-10%) who have severe or recurrent (recurring) nosebleeds need to see an ear, nose, and throat specialist or an emergency department.
