Nasal Cauterization

Burning or destroying tissue is called cauterization. The procedure is used to fight infections, close amputation wounds, and to stop bleeding. Nasal cauterization is used to stop excessive nosebleeds – usually from an artery or vein in the tip of the nose. In nasal cauterization, heat is applied to a bleeding point and the heat seals the blood vessel by burning it slightly which stops the flow of blood. Cauterization takes just a few minutes to do and it can be done in a doctor's office or an outpatient department under local anesthesia. Why is nasal cauterization performed? What can you expect during the procedure and how you should care for your nose afterwards?

Why Is Nasal Cauterization Performed?

The nose has a rich blood supply that keeps inhaled air warm and moist on its journey to the lungs. The large amount of blood sometimes leads to nosebleeds (epistaxis), particularly in young adults and children. Trauma, infection, or a drying of the nose membranes causes nosebleeds. Nose picking, heavy sneezing, hard coughing, vigorous exercise, and excessive blowing are examples of trauma that lead to nosebleeds. The spontaneous bleeding usually comes from an engorged single vein in the septum (partition wall) that is often visible and accessible. If repeated bleedings persist and do not stop, it may be necessary to perform nasal cauterization.

How Is Nasal Cauterization Performed?

Nasal cauterization is performed by two methods and it’s a quick and painless procedure.

Methods Used

• A platinum needle is heated with electricity and placed in the nostril to seal the blood tissues.
• Caustic agents such as a silver nitrate stick use chemical reactions to seal the blood tissues.

Procedure

Nasal cauterization is a minor and fast procedure that does not require any prior preparation by the patient. Below are the steps used in nasal cauterization.

• Nostril inspection. Each nostril is examined with a light and speculum to determine the point and cause of bleeding.
• Blood test. A sample of blood is taken from the nose to determine if anti-clotting elements are present and it is also tested for anemia.
• Local anesthetic. A local anesthetic is applied to the nose by using a piece of cotton packed into the nostril to numb it and prevent pain.
• Cauterization. Once the nose is numb, an electrocautery needle or stick coated silver nitrate stick is placed on the bleeding point and its tissues. The heat causes the blood vessels to melt and fuse together which seals the rupture and causes it to stop bleeding.

How to Care After Nasal Cauterization Procedure

Once the nosebleed is cauterized and the bleeding stopped, no further treatment is needed. However, for a week after the procedure, a patient must be careful not to rupture the cauterized seal or the bleeding will re-occur. Any activity that manipulates the nose could cause re-bleeding from the cauterized area during the first seven to 10 days. If the bleeding starts again, contact your physician immediately.

The following preventive behaviors will decrease the risk of rupturing the seal.

• Avoid blowing the nose if possible.
• When sneezing, always keep the mouth open.
• Avoid any tobacco or alcohol for one week.
• Keep nose lubricated by using nose drops regularly.
• No heavy lifting, straining, or vigorous cardiovascular exercise for one week.

Patients report mild nasal pain or burning for a few to several days following cauterization. This is usually well controlled with Tylenol® as directed or relieved by spraying the nasal passages with saline solution.

Don’t Overdo Nasal Cauterization

It is important to remember not to overdo nasal cauterization. Multiple cauterizations can do more harm than good over the course of time. Nasal cauterizations should be used with prudence and not every time one gets a bad nosebleed. Nosebleeds are easy to control. They can be controlled by a cold compress placed across the bridge of the nose. In many cases, one can sit down and lean forward or squeeze the ridge of the nose until the bleeding stops.

It’s recommended by physicians to only have only one nasal cauterization done in each nostril and at separate times. Repeated cauterizations or having cauterizations in both nostrils at the same time can weaken the nose and cause holes to form inside of it. These holes usually occur in the septum and once the holes are there, they are permanent. Holes in the nose lead to nosebleeds, sinus infections, a decreased resistance to colds, and breathing difficulties.