Bellocq tamponade
The so-called Bellocq tamponade or posterior nasal tamponade is used to stop nosebleeds ( epistaxis ) if there is a source of bleeding in the posterior segments of the nose.
application
The Bellocq tamponade is performed under local anesthesia or (better) general anesthesia.
A soft catheter is pushed through the nose into the throat and from there out of the mouth with grasping forceps. A strong thread is attached to the catheter, the one at the other end gauze - tampon has incorporated. The catheter and the thread are now pulled out of the nose, whereby the tampon is pulled into the nasopharynx and there closes the rear nasal opening ( choane ). Then the nose is supplied with a front tamponade and the thread of the tampon is fixed to the nose. The cavity of the nose ( Cavum nasi) is now closed from the front and back so that the bleeding has to stop, even if the bleeding site is not directly compressed by the tampon.
More gentle, but not always sufficient, is to use a balloon catheter , which is pushed through the nose to the nasopharynx and whose balloon is inflated with saline solution. The balloon is now pressed into the choane by pulling on the catheter and the catheter itself is fixed at the nasal entrance after a front nasal packing. So-called pneumatic nasal tampons are also available, which are pushed into the nose up to the nasopharynx and filled with air. The entire nasal cavity is filled and compressed.
As an alternative to tamponade, there may be the option of endoscopic coagulation of the sphenopalatine artery .
History
The first description of a posterior nasal packing comes from Henry François Le Dran (1685–1770), who used delicate pliers to pull a thread with a finger behind the uvula and an attached tampon through his nose. A similar procedure was already described by Hippocrates, but for the removal of a nasal polyp.
The name Bellocq is mentioned in the 19th century in connection with a device for the posterior nasal packing. However, whoever was the first to describe this instrument cannot be reconstructed from the literature, nor can the correct spelling (Bellocq, Belloc, Belloq). The device was a metal tube with a metal spring sliding in it, which was pushed through the nose into the nasopharynx and thus made it possible to pull the thread with the tampon forward, where it was fixed. J.-F.-L. Deschamps described in his book "Traité des maladies des fosses nasales et de leurs sinus" (1803) that the posterior nasal packing had become less dangerous thanks to the elastic probe from Bellocq, without further details on the person of Bellocq. Voltolini named Jean-Louis Belloc (1730-1807), author of a forensic medical treatise, as the inventor, which is probably due to a confusion with the author of the publication "Sur quelques hémorragies particulières, et sur moyen d'y remédier" named M. Belloq. However, there is no mention of nosebleed in this publication.
Although often mentioned, the Bellocq instrument or the Belloq tube allegedly invented by the aforementioned JL Belloq may have been used little. As early as the 19th century, a soft rubber catheter was often recommended as an alternative.
Regardless of the fact that neither the person of Bellocq nor the spelling of the name can be clearly stated, the name “der Bellocq” has become a synonym for the posterior nasal packing, at least in German-speaking countries.
swell
- ^ Meyer's Large Conversational Lexicon . 6th edition. Bibliographisches Institut, Leipzig / Vienna 1909 ( zeno.org [accessed on April 3, 2019] Lexicon entry “Belloqsche Röhre”).
- ↑ H. Feldmann: Nosebleeds in the history of rhinology . Laryngo-Rhino-Otol. 75, 1996, pp. 111-120
literature
- Zenner H.-P .: Practical therapy of ear, nose and throat diseases. Schattauer (1993), Stuttgart