Intranasal bleeding
Chronic sinusitis
Intranasal bleeding
Around 10% of general population suffers from spontaneous nose bleeding (not related to a surgical intervention), of which 10% needs specific medical management (1).
Intranasal bleeding (epistaxis) are from various origins:
General causes: clotting disorders, genetic diseases
Traumatic causes: face and nasal bones fracture, intranasal drugs intake, nasal surgery, nasal intubation, fibroscopy
Tumoral causes: cancers (sinus, nasopharynx,…), benign tumors (nasopharyngeal fibroma)
Inflammatory causes: infectious rhinitis
Surgical causes: sinus surgery, ENT/maxillofacial cancer surgery, endoscopic pituitary surgery (neurosurgery)
Epistaxis can provoke the following symptoms:
anemia, cold sweat, paleness, fatigue, dizziness or sensation of thirst, excitation or somnolence.
In rare cases, it can be life-threatening (2)
Intranasal bleeding is very common, costly and have a negative impact on patients quality of life. In particular chronic cases (3), epistaxis also greatly impact caregivers quality of life. The “disease” incidence is increasing due to population ageing and, mechanically, the growth of the number of patients suffering from cardiovascular diseases and treated with anticoagulants.
(1) Changing Trends in the Management of Epistaxis, Traboulsi H et al. International Journal of Otolaryngology Volume 2015
(2) https://biology.stackexchange.com/questions/19827/can-nosebleeds-cause-death
(3) Patients « Rendu-Osler »
Chronic sinusitis
About 12% of the population suffers from chronic sinusitis (1), i.e. 900 million patients worldwide. It is the 5th most frequent disease amongst people aged below 65 years (2). It is more frequent than cardiovascular diseases.
Chronic sinusitis is an inflammatory disease in which sinus mucosa is swollen and inflamed (Figure 1).
FIGURE 1 –Sinusitis : illustration
Chronic sinusitis is caused by:
allergies (rhinitis)
deviated nasal septum
nasal polyps
other medical conditions (e.g. HIV)
Chronic sinusitis can provoke the following symptoms:
respiratory issues and loss of sense of taste and smell.
chronic headaches and body pain
recurrent infections (including meningitis)
Persistence of those symptoms can seriously impair daily patients wellness, which causes:
frequent physician visits, regular sick leaves, chronic fatigue and even depression (3)
Approximately 45% of patients suffering from chronic rhinosinusitis suffer from asthma (4)
Close to 65% of patients with AIDS have chronic sinusitis as a comorbidity (5)
Chronic sinusitis also increases the risk of ischemic and hemorrhagic stroke (6)
Disease incidence is also increasing (7, 8, 9). This could be explained by pollution growth (industrial or caused by urgent expansion) and antibiotics resistance (10, 11), which usage in sinusitis represents 21% of total antibiotics prescriptions (12) in adults in the US.