In vitro surface temperature of nasal balloons during hot water inflation

Background: Posterior epistaxis is often treated with nasal packing by balloon compression or gauzes, and in refractory cases, with ligation of the sphenopalatine artery. These methods are painful, require admission and imply a substantial risk of complications. It has been shown that hot water irrigation is effective to stop bleeding. However, the hot water procedure is associated with patient discomfort, and temperatures over 520C may cause tissue necrosis. The use of nasal balloons filled with hot water may potentially be equally effective and cause less discomfort, but has not yet been studied. The aim of this study was to determine the surface temperature of nasal balloons when filled with hot water. Methodology: An in vitro study was performed to determine surface temperature of Epistat® and Rapid Rhino® nasal balloons when filled with water at different temperatures. Results: There was a strong correlation between inserted water temperature and maximum temperature at Epistat® balloon surface. Maximum surface temperature occurred during the first 30 seconds after water insertion and there was a rapid temperature decline irrespective of inserted water temperature. There was a similar correlation for Rapid Rhino®. However, surface temperatures were in general lower, maintained for a longer period and the peak temperature occurred later. Conclusions: Hot water inflation in nasal balloons seems to be feasible and is unlikely to cause tissue necrosis with inserted water temperatures of 600C or less.