Septal Release: A Targeted Surgical Strategy for Recurrent Epistaxis

ABSTRACT Background Recurrent epistaxis is a common pediatric condition that is typically managed with conservative therapies, but a subset of patients require surgical intervention after treatment failure. We seek to describe the efficacy of septal release for refractory pediatric epistaxis patients. Objective To compare outcomes of septal release for refractory epistaxis in pediatric patients with and without underlying bleeding disorders. Method A retrospective review was performed of 19 pediatric patients who underwent septal release for recurrent epistaxis from 2014 to 2024. We compared demographics, number of pre‐operative epistaxis episodes, pre‐operative treatments (ointments, nasal saline, chemical decongestants, chemical cauterizations), and post‐operative annual epistaxis episodes among patients with and without bleeding disorders. Bleeding disorders included von Willebrand disease, thalassemia, platelet dysfunction, and dysfibrinogenemia. Results Five patients had bleeding disorders; 14 did not. There was a significantly lower rate of epistaxis post‐septal release in patients without bleeding disorders ( p = 0.016). Patients with bleeding disorders showed a decrease in episodes, though not statistically significant. Conclusion Septal release is an effective and safe treatment for refractory pediatric epistaxis, providing the most significant benefit to those without underlying coagulopathies.