Long-term efficacy assessment of current treatment options for epistaxis in HHT.

Dür, Cilgia; Anschütz, L.; Negoias, S.; Bulut, O. C.; Angelillo-Scherrer, A.; Caversaccio, M. (2021). Long-term efficacy assessment of current treatment options for epistaxis in HHT. European archives of oto-rhino-laryngology, 278(11), pp. 4321-4328. Springer 10.1007/s00405-021-06701-z

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PURPOSE

Hereditary hemorrhagic telangiectasia (HHT) is a vascular disorder that presents with recurrent, intractable epistaxis. The aim of this study was to retrospectively analyze the efficacy of various treatment options for epistaxis in patients with HHT, over a period of 18 years, and to correlate these findings with available evidence in the literature.

METHODS

Records of patients with HHT, treated for epistaxis between 2000 and 2018 were analyzed. Treatment procedures carried out and their efficacy were extracted and analyzed.

RESULTS

Forty-three records were evaluated. All patients were given nasal humidifying ointments, 93% required acute treatment with bipolar electrocautery, and 60% underwent atraumatic nasal packing. Recurrent cases were treated medically with tranexamic acid (26%), oestrogen (19%), and bevacizumab (2%). Laser photocoagulation was done in selected cases (40%) and if unsuccessful, septal dermoplasty was performed (2.3%). Endovascular embolization was reserved for life-threatening emergencies (7%).

CONCLUSION

Epistaxis in HHT is not curable, but can be managed by employing a comprehensive stepwise approach. An algorithm for effective and comprehensive management has been presented.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > School of Dental Medicine > Department of Orthodontics
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Dür, Cilgia; Anschütz, Lukas Peter; Negoias, Simona Nicoleta; Angelillo, Anne and Caversaccio, Marco

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0937-4477

Publisher:

Springer

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

27 Apr 2021 15:04

Last Modified:

03 Oct 2021 01:31

Publisher DOI:

10.1007/s00405-021-06701-z

PubMed ID:

33661356

Uncontrolled Keywords:

Bevacizumab Epistaxis Hereditary hemorrhagic telangiectasia Laser photocoagulation Rendu-osler Rhinology

BORIS DOI:

10.48350/154685

URI:

https://boris.unibe.ch/id/eprint/154685

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