Outcome of Hyaluronic Acid Gel Versus Petroleum Jelly in Treatment of Epistaxis

The aim of this study is to compare the efficacy of Hyaluronic Acid Gel with Petroleum Jelly in treatment of epistaxis.

Study Overview

• Status: Not yet recruiting
• Conditions: Epistaxis
• Intervention / Treatment: Drug: Hyaluronic Acid Gel; Drug: Petroleum jelly

Detailed Description

• Epistaxis is one of the most common otorhinolaryngologic emergencies. It affects up to 60% of the population during their lifetime, with 6% requiring medical attention. The greatest peaks in the overall incidence occur in individuals under 10 years of age and over 40 years of age.
• In 1879, James Little identified an arterial plexus on the anterior septum as a frequent site of bleeding and the same plexus was described one year later by Kiesselbach. As a result of these descriptions, the area most frequently implicated in epistaxis is known as Little's area or Kiesselbach plexus which is anatomically formed by the anastomosis between the terminal branches of the external and internal carotid arteries (Anterior ethmoidal artery, Septal branch of Superior labial artery, Septal branch of Sphenopalatine artery, Septal branch of Greater palatine artery) .
• The most common etiology of epistaxis is idiopathic in 80%-90% of cases, no precipitating causes can be identified. Of the other identifiable local causes of epistaxis, the most frequent are trauma, nasal neoplasm, iatrogenic or due to systemic factors (hypertension, coagulopathy, inflammatory conditions, infectious diseases, vessel wall fibrosis in associated with ageing), use of drugs (anticoagulant, antiplatelet, nonsteroidal anti-inflammatory nasal sprays) and congenital nasal septal abnormalities .
• Management of recurrent anterior epistaxis can be done by cautery (chemical or electrical), anterior nasal packing or Surgical therapy if the other methods failed .
• This protocol outlines standardized guidelines for the use of Hyaluronic Acid (HA) in epistaxis management for nasal mucosal hydration, healing, and recurrence prevention. It is suitable for use in ENT clinics, emergency departments, and hospital wards.

• Mechanism of action of Hyaluronic acid:

  1. Hydration: Binds large amounts of water, maintaining skin moisture and elasticity.
  2. Wound healing: Promotes keratinocyte and fibroblast proliferation, enhancing tissue repair and regeneration.
  3. Anti-inflammatory effect: Reduces inflammatory cytokines and modulates immune response.
  4. Barrier protection: Forms a protective layer that prevents water loss and protects against irritants and microbes.
  5. Collagen stimulation: Supports collagen synthesis and improves skin structure.
  6. Antioxidant action: Scavenges free radicals, reducing oxidative damage.

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Marina Emil Kamal Kaml, M.B.B.CH; Phone Number: +201274047194; Email: Mareena.20134245@med.aun.edu.eg
• Study Contact Backup: Name: Ahmed Ragab Sayed, Lecturer; Phone Number: +201099924177; Email: ahmedsayed12345@aun.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients with anterior localized idiopathic epistaxis

Exclusion Criteria:

• Patients wit secondary epistaxis (posttraumatic, postoperative, tumoral).
• During pregnancy.
• Patients wit major systemic disease (Blood Disease, Hypertension).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Hyaluronic Acid Gel; "Participants in this group will receive topical hyaluronic acid gel applied to the nasal mucosa for the treatment of epistaxis. The application will be done as per the study protocol, and outcomes will be monitored over the study period."	Drug: Hyaluronic Acid Gel; "Topical hyaluronic acid gel will be applied to the nasal mucosa of participants for the treatment of epistaxis. The gel will be administered according to the study protocol and frequency, and outcomes will be assessed throughout the study period."
Experimental: Petroleum Jelly; "Participants in this group will receive topical petroleum jelly applied to the nasal mucosa for the treatment of epistaxis. The application will follow the study protocol, and outcomes will be monitored over the study period."	Drug: Petroleum jelly; "Topical petroleum jelly will be applied to the nasal mucosa of participants for the treatment of epistaxis. The application will follow the study protocol, and outcomes will be monitored and recorded over the study period."

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To compare the recurrence rate of epistaxis between the two groups	"Proportion of participants whose epistaxis stops completely within 7 days of treatment application."	14 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To assess time to symptom resolution	"Time in minutes or hours from first application to complete cessation of nasal bleeding."	Within 24 hours
To evaluate mucosal healing (endoscopic findings)	"Assessment of nasal mucosa healing using endoscopic examination after application of hyaluronic acid gel or petroleum jelly, scored according to a standardized mucosal healing scale."	7-14 days
To assess patient comfort and compliance	"Measured using a standardized questionnaire or visual analog scale during the treatment period."	7 days
To record adverse effects	"Incidence of local irritation, allergic reactions, or other side effects related to the topical intervention."	14 days

Collaborators and Investigators

• Sponsor: Assiut University
• Investigators: Study Director: Ahmed AbdelAleem AbdelWahab, Prof

Publications and helpful links

Helpful Links

• Daniel B and Nick S,(2010) Epistaxis; Cummings Otolaryngology head and neck surgery, volume 1, ch45:p682. fifth edition.
• Comparison of local sclerotherapy with Lauromacrogol versus nasal packing in the treatment of anterior epistaxis. Clinical and Experimental Otorhinolaryngology.2016;9:131-135.

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): April 1, 2028
• Study Completion (Estimated): June 1, 2028

Study Registration Dates

• First Submitted: April 9, 2026
• First Submitted That Met QC Criteria: April 9, 2026
• First Posted (Actual): April 15, 2026

Study Record Updates

• Last Update Posted (Actual): April 22, 2026
• Last Update Submitted That Met QC Criteria: April 18, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Hemorrhage; Nose Diseases; Otorhinolaryngologic Diseases; Signs and Symptoms, Respiratory; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Epistaxis; Organic Chemicals; Hydrocarbons; Petrolatum
• Other Study ID Numbers: HAvsPJ-EPI

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No