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Background and Objectives: To investigate the common site of recurrent epistaxis after initial intervention such as packingand cauterization had failed and to evaluate the efficacy of surgical endoscopic electrocautery. Subjects and Method: Retrospective review of 47 patients with recurrent and uncontrolled idiopathic epistaxis betweenOctober 1995 and March 2016. All patients underwent endoscopic examination in the operating room after hospitalization. Weperformed electrocautery when a bleeding site was found. Results: The most common sites of bleeding were the inferior meatus (28%), sphenoethmoid recess (23%), superior septumaround the olfactory cleft (13%), and the posterior end of the middle turbinate (15%). There was no serious complication duringthe one week after surgery. In 46 (98%) patients, refractory epistaxis was successfully controlled. One patient had recurrent epistaxisafter electrocautery and underwent endoscopic sphenopalatine artery ligation. Conclusion: In patients with refractory idiopathic epistaxis after failure of first-line treatment, endoscopic examinationthrough a surgical approach and electrocautery for suspected bleeding are effective.
