Removing Nasal Packing in Epistaxis: What to Do in the Case of an Undeflatable Foley Catheter Balloon
31 October 2011
04 December 2011
25 October 2013 (online)
Introduction Undeflatable Foley catheter balloons adapted for use as nasal packing in epistaxis represent a possible complication.
Case Reports We report on three cases in which Foley catheter balloons adapted for use as posterior nasal packing in epistaxis failed to deflate. In one patient, deflation was achieved by simply using the fingertips to massage the segment of the catheter collapsed by the fixation device. In the second case, the Foley balloon was removed by the oral route after sectioning the catheter. In the third patient, the Foley catheter was successfully deflated after sectioning.
Discussion The probable causes of the undeflatable balloons in these cases were a blockage or lumen collapse of the balloon or a malfunction in the valve system. Although no definitive method has been established for dealing with this complication, the options proposed are the following: manipulation to restore the permeability of the segment of the catheter collapsed by the fixation device, if this is the case; sectioning the catheter or inserting a stiletto catheter; bursting the balloon; or removing it by the oral route. The latter option is apparently the most appropriate for the otolaryngologist in cases unrelated to simple collapse caused by the fixation device.
- 1 Stemm RA. Complications of nasal packing. Ear Nose Throat J 1981; 60: 461-462
- 2 Choy ATK, John DG, van Hasselt CA. Posterior epistaxis and the undeflatable Foley's urinary catheter balloon. J Laryngol Otol 1993; 107: 142-143
- 3 Gaspar-Sobrinho FP, Lessa HA. Fixação da sonda de Foley no tratamento da epistaxe posterior e prevenção de lesões à asa do nariz. Arq Otorrinolaringol 2003; 7: 272-276
- 4 Pohl FF, Petroianu A. Tubos, sondas e drenos. 1st ed. Rio de Janeiro, Brazil: Guanabara Koogan; 2000
- 5 O'Flynn KJ, Thomas DG, Hardy A. Harpoon device for removal of obstructed balloon catheters. Br J Urol 1992; 69: 217
- 6 Moffat LEF, Teo C, Dawson I. Ultrasound in management of undeflatable Foley catheter balloon. Urology 1985; 26: 79
- 7 Addonizio JC, Sayegh N, Sayegh N. Management of undeflatable Foley catheter balloon. Urology 1982; 19: 318
- 8 Conn IG. Undeflatable Foley catheter balloons: a simple solution. Urology 1987; 30: 275
- 9 Saxena A, Khanna S, Vohra BK. Endoscopic management of the undeflatable Foley catheter balloon. Br J Urol 1992; 69: 217-218
- 10 Gaspar-Sobrinho FG, Damasceno EP, Lessa HA, do Valle AC. Instrumentos para fixação da sonda de Foley no tratamento da epistaxe posterior e prevenção de lesões à asa do nariz. In: Anais do III Congresso Triológico de Otorrinolaringologia; 2003; Rio de Janeiro, Brazil
- 11 Gaspar-Sobrinho FP, Damasceno EP, Esperidião AC, Lessa HA. Efeito de lubrificantes sobre a integridade da sonda de Foley e implicações no tamponamento nasal para epistaxe. Rev Bras Otorrinolaringol (Engl Ed) 2004; 70: 7-10
- 12 Chrisp JM, Nacey JN. Foley catheter balloon puncture and the risk of free fragment formation. Br J Urol 1990; 66: 500-502
- 13 McFerran DJ, Edmonds SE. The use of balloon catheters in the treatment of epistaxis. J Laryngol Otol 1993; 107: 197-200