I have recurrent epistaxis with bruxism and ETD. Could it be due to sinusitis?

Hello,

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You have recurrent epistaxis and you have been cauterized also a number of times. There does not seem to be any obvious pathology on examination by endoscopy. I must point out that epistaxis can be idiopathic in more than 50% patients. This is because certain patients tend to have nasal mucosa far more friable than others and susceptible to even most trivial trauma like nose picking or forceful blowing. Even minor colds can cause epistaxis. However, one has to be careful to rule out other causes. Hypertension is an important cause but that is usually an affliction of elderly. At your age, one would like to rule out bleeding diathesis. Did you ever have bleeding from any other site? Have you done a coagulation profile, though you have mentioned blood tests? What about liver and renal function tests? Are you on any medication other than this? Further deviated nasal septum with spurs can cause epistaxis. Did MRI mention anything like that? In case there is nothing to suggest any underlying cause, it is likely to be idiopathic. And role of precautions become all that necessary. One important thing is to prevent your nose from becoming dry as occurs in dry weather and colds. You can use liquid paraffin nasal drops to prevent mucosa from becoming dry and friable. Further you need to avoid blowing hard or frequent cleaning of nose. You can also use topical decongestants like Xylometazoline 0.02% if you develop a bleed. Avoid using them for more than seven days at stretch. You can go for a CT (computed tomography) nose and PNS (para nasal sinus) for having a better information on sinus details.

Hi,

Welcome back to icliniq.com.

Well, it is the bleed from the nose that you cough up as nasal cavity directly opens up into throat which communicates with the mouth. Since there is no obvious pathology, the cause is most probably not a serious one and all you need to do is to prevent and treat early. If they are able to find a bleeding vessel it can be cauterized endoscopically. Take precautions as required and use medications that I have mentioned. You can get a CT nose and PNS done to rule out any pathology that might have been missed if at all bleeding is severe. One important cause that has to be ruled out for your age which can cause torrential unprovoked bleeding is Juvenile angiofibroma but then the mass should have been visible at endoscopy and should have been picked by MRI. Further, it would cause symptoms of nasal obstruction. I do not think there is anything to worry about.