Nasal cautery: Caring for your child at home

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Nasal cautery is a treatment for nosebleeds. Learn how the treatment works and how to care for your child as they recover at home.

Key points

Nasal cautery uses electricity to seal blood vessels in the nose that bleed regularly.
After the surgery, your child's nose will be packed with a special sponge and Polysporin to protect it while it heals.
Your child will feel congested and may have difficulty breathing through their nose for about a week after the procedure.
For a week after surgery your child must not blow their nose, pick their nose, bend over or lift anything heavy, or take part in any activity that requires a lot of energy.

Introduction

Identification of nasal septum and blood vessels in a child’s nose — The two nostrils are divided by a wall called the nasal septum. The septum is rich in blood vessels. If they bleed regularly, the blood vessels can be sealed with nasal cautery.

Nasal cautery is a type of surgery (operation) to treat nose bleeds. It involves using electricity to seal blood vessels in the nose that bleed regularly.

Preparing for the treatment

Does my child need to do anything to prepare for nasal cautery?

There is no special preparation for nasal cautery. The doctor examines each nostril to look for the bleeding point and any other possible causes of bleeding.

Treatment

What happens during surgery?

Before the surgery, your child will have a special "sleep medicine" called a general anaesthetic. This will make sure your child sleeps through the operation and does not feel any pain.

The surgeon will then use an instrument called an electrocautery needle to pass electricity to the area of the nosebleeds. The electricity burns the tissue slightly where bleeding usually occurs. When the tissue heals, it becomes thicker. This prevents further nosebleeds.

After the treatment

What happens after surgery?

Once the surgery is finished, the surgeon will use a special sponge, such as Gelfoam or Surgicel, to pack your child's nose. The surgeon will also fill the nose with Polysporin. Together, the packing and Polysporin protect the burned tissue in your child's nose while it heals. The packing will dissolve after three to five days.

Your child will usually then be sent home on the same day as the surgery.

Helping your child

How do I care for my child at home?

Your child's nose will feel congested (blocked) for up to one week after surgery. As a result, they may find it difficult to breathe through their nose. This is normal.

If your child is in pain, you can give them acetaminophen. Avoid giving ibuprofen for two weeks after cautery.
If there is crusting in your child's nose, use a saline spray two to four times a day to loosen it. You can start using the spray three to five days after surgery or once the packing has dissolved.
If your child's nose feels dry or irritated, use Polysporin or Vaseline to lubricate (moisten) it.
Consider using a cool air humidifier at night while your child is sleeping. This will keep the air moist and be more comfortable for your child while their skin is healing from the surgery.
Have your child sleep in a slightly upright position, supported by pillows, for the first week or so after surgery. This may be more comfortable for your child than lying flat in the bed.

What your child must avoid after nasal cautery

For the first week after surgery, your child must not:

blow their nose - they can wipe it gently with a tissue instead
bend over or lift anything heavy
take part in any activity that requires a lot of energy, such as swimming or contact sports like hockey or football
pick their nose - if your child picks their nose at night, it may help them to sleep with socks on their hands.

What your child can do

Your child can return to normal activity as soon as they feel able.

When to seek medical attention

When should I call a doctor?

Call your doctor if:

your child has a fever (a temperature of 38°C (100°F) or higher)
your child has a nose bleed that does not stop after 20 minutes of continuous pressure to the nose
there is any vomiting with specks of blood
a foul smell or green fluid comes from your child's nose.

At SickKids

If there are problems in the first 24 hours after the procedure, please call 416-813-7500 and ask for the ENT resident on call.

For any other questions, you may call the ENT clinic nurse at 416-813-6452.

Last updated: February 7th 2014