Monday, March 15, 2010

A novel method of handling Little's area bleeding


Many a time we would have faced problems cauterizing a Little's area bleed. This is basically due to the use of nasal speculum which obscures the field and also keeps one hand occupied. Bray in his " How I do it" describes how he put to use the Mallet spint.


A Mallet splint is a common tool used to treat Mallet (Trigger) finger. This splint is available in different sizes. It can be cut and introduced into the anterior nares. This keeps the nasal cavity open providing a good view of nasal septum area. It also has the advantage of leaving both the surgeon's hand free. The most proximal part of the Mallet splint is cut and shaped into a "U" shaped splint. This splint can be readily inserted into the nasal cavity. Since this splint is made of silastic, its memory holds the nasal cavity open.

Since both the hands of surgeon are free the bleeder can easily be cauterized either by electro or chemical cautery.

Figure showing Mallet splint

 Figure showing modified splint inside anterior nasal cavity

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