Why does it form and bleed?
The anteroinferior section of the nasal septum is rich in blood vessels and located superficially, so this is where nosebleeds most often begin. If the mucous membrane is repeatedly injured, in response to damage and inflammation, a rapid proliferation of capillaries is formed - a formation with a thin, vulnerable surface and a well-developed feeding vessel. It increases rapidly in the first weeks, then growth slows down. It is the abundance of blood vessels that explains why bleeding occurs from almost any touch and is difficult to stop with ordinary home measures.
- Localization - anterior nasal septum
- The formation consists of overgrown capillaries
- The surface is easily damaged
- Grows quickly in the first weeks
- Not associated with common sinusitis polyps
Causes and risk factors
Most often, the formation is preceded by chronic trauma: the habit of touching the nose with a finger, frequent intensive nose blowing, prolonged use of vasoconstrictor drops, working in a dusty room. Dry air in winter and in air-conditioned rooms dries out the mucous membrane, making it brittle. Separately, formations that appear during pregnancy against the background of changes in hormonal levels and blood supply to the mucous membrane are distinguished; they often decrease after childbirth. Drugs that affect blood clotting and clotting disorders increase the risk of bleeding.
- Mechanical trauma to the mucous membrane
- Dry air and dust
- Long-term use of vasoconstrictor drops
- Pregnancy
- Taking blood thinners
- Blood clotting disorders
- Deviated septum with prominent ridge
Symptoms
The main complaint is repeated bleeding from the same side of the nose. At first they are small, in the form of streaks of blood on a napkin when you blow your nose, then they become more frequent and more abundant. Between episodes, a foreign body or crusty sensation in the nose may be bothersome. With a large formation, one-sided congestion appears. Over time, frequent blood loss leads to weakness, fatigue and pallor - signs of decreased hemoglobin. There is usually no pain, and it is painlessness that often makes you postpone a visit to the doctor.
- Repeated bleeding from one nostril
- Streaks of blood when blowing your nose
- Sensation of a foreign body in the nose
- Unilateral congestion
- Crusts and dry nose
- Weakness and pallor with frequent blood loss
Diagnostics
An experienced ENT doctor often sees a formation already during anterior rhinoscopy: a bright red or bluish nodule on a stalk is identified on the septum, bleeding easily when touched. An endoscopic examination of the nasal cavity clarifies the size, exact location of attachment and condition of the remaining sections, and also excludes the source of bleeding in the deep sections. A blood test shows the degree of anemia, a coagulogram shows coagulation disorders. An obligatory part of the treatment is a histological examination of the removed tissue: it confirms the benign nature of the formation.
- Anterior rhinoscopy
- Endoscopy of the nasal cavity
- Clinical blood test
- Coagulogram
- Histological examination of distant formation
- CT scan of the sinuses if another source is suspected
Treatment and prevention
In case of active bleeding, first stop the bleeding: press the wing of the nose against the septum for 10–15 minutes, tilting the head forward; if necessary, the doctor performs anemization of the mucous membrane or tamponade. Radical treatment - removal of the formation along with the base and treatment of the bed, often endoscopically and under local anesthesia; An outpatient procedure is usually sufficient. Simply cauterizing the surface without removing the base often causes bleeding to return. After the intervention, it is important to moisturize the mucous membrane with saline solutions, not pick your nose, and maintain air humidity at home. The doctor can observe formations that appear during pregnancy before birth.
- Correct first aid: press the wing of the nose, tilt the head forward
- Don't throw your head back
- Removal of formation from the base and coagulation of the bed
- Endoscopic control during surgery
- Moisturizing the mucous membrane with saline solutions
- Quitting the habit of touching your nose and long-term vasoconstrictor drops
- Maintaining indoor air humidity
