How we do it: a practical approach to Foley catheter posterior nasal packing.

KEY POINTS: There are various effective treatment options for refractory posterior epistaxis including endoscopic diathermy or endoscopic artery ligation. If these treatment options are not immediately available, posterior nasal packing with Foley catheter is an effective and rapid non-surgical treatment alternative. A systematic approach is presented. The principles and mechanisms of action of the posterior nasal packing are explained. Nevertheless, there are morbidities involved and posterior packing can be painful and uncomfortable for the patient. Marking and modifying the catheter will help one inflate the balloon in the correct place and avoid the problem of nasal alar pressure necrosis.