Argon plasma coagulation is an effective treatment for hereditary hemorrhagic telangiectasia patients with severe nosebleeds

Pagella, Fabio; Matti, Elina; Chu, Francesco; Pusateri, Alessandro; Tinelli, Carmine; Olivieri, Carla; Canzonieri, Cecilia; Boeri, Laura; Ornati, Federica; Danesino, Cesare

doi:10.3109/00016489.2012.718097

Cited by 17 publications

(13 citation statements)

References 18 publications

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“…25 At the same institution, a retrospective analysis of 43 patients diagnosed with hereditary haemorrhagic telangiectasia reported substantially reduced bleeding in 36 patients after treatment. Of the 18 patients who had previously needed blood transfusions, 13 reported a substantial reduction in bleeding after treatment, with no blood transfusions necessary.…”

Section: Argon Plasma Coagulationmentioning

confidence: 97%

Evidence-based management of epistaxis in hereditary haemorrhagic telangiectasia

Syed

Sunkaraneni

2015

J. Laryngol. Otol.

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There is a lack of high-level evidence for the use of many of the available treatments for the specific management of epistaxis in hereditary haemorrhagic telangiectasia. Current management should be based on a multidisciplinary team approach involving both a hereditary haemorrhagic telangiectasia physician and an ENT surgeon, especially when systemic therapy is being considered. The suggested treatment algorithm considers that the severity of epistaxis merits intervention at different levels of the treatment ladder. The patient should be assessed using a reproducible validated assessment tool, for example an epistaxis severity score, to guide treatment. More research is required, particularly in the investigation of topical agents targeting the development and fragility of telangiectasiae in hereditary haemorrhagic telangiectasia.

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Section: Argon Plasma Coagulationmentioning

confidence: 97%

Evidence-based management of epistaxis in hereditary haemorrhagic telangiectasia

Syed

Sunkaraneni

2015

J. Laryngol. Otol.

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“…For example, plasma has been used to improve the hydrophilicity of the surface of petri dishes and the adhesion of hydroxyapatite to the surface of joint prostheses [6,7]. In medical practice, the argon plasma coagulation method has been widely used to attain hemostasis within the gastrointestinal tract under gastrointestinal endoscopy and to inactivate tissues [8], and to attain hemostasis of epistaxis in otorhinolaryngology [9]. Its use in cancer treatment and chronic wounds has been promoted [10,11].…”

Section: Introductionmentioning

confidence: 99%

Sterilization Method Using Plasma Discharge Against Biofilm-Producing Pseudomonas aeruginosa on Surface of Contact Lens

et al. 2015

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Pseudomonas aeruginosa is the main causative bacteria of contact lens (CL)-associated microbial keratitis. Generally, multi-purpose solutions (MPSs) are widely used for washing, disinfection, and storage of CLs. However, the sterilization effect of an MPS against biofilm-producing P. aeruginosa is insufficient. The aim of the present study is to evaluate the bactericidal effect against biofilm-producing P. aeruginosa on CLs using plasma discharge. The standard strain of P. aeruginosa, PAO1, was used to make a biofilm-formed contamination model. The bactericidal effect of five MPSs and plasma discharge against biofilmproducing P. aeruginosa was observed using the culture method, scanning electron microscopy, and fluorescence microscopy. Plasma discharge was produced for 3, 5, or 10 min. Temperature, pH, and the concentrations of ozone (O 3 ), hydrogen peroxide (H 2 O 2 ), and nitrogen dioxide (NO 2 ) in the discharged water were monitored. None of the tested MPSs showed a bactericidal effect after 4 h. In contrast, biofilm-producing P. aeruginosa strains were sterilized within 10 min using plasma discharge. Moreover, it was confirmed using fluorescence microscopy that there was no viable bacterium on the surface of the contamination model irradiated for 10 min. Although the concentration of O 3 was 5 ppm after 3 min of discharge, it gradually decreased subsequently. Both NO 2 and H 2 O 2 concentrations gradually increased. Water temperature rose from 18 to 45°C, and pH changed from 6 to 2. The results show that plasma discharge may be effective for the sterilization of biofilm-producing P. aeruginosa on CLs.

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“…HHT patients with severe epistaxis often seek medical attention to help control this debilitating and unpredictable issue. A range of interventions can be employed including nasal packing, hormone therapies, monoclonal antibodies, local sclerotherapy, diathermy, and various coagulation and cautery techniques that often demonstrate at least short‐term effectiveness . Coagulation and cautery techniques have consistently shown benefit, but most patients experience a recurrence of their symptoms within 1–2 years .…”

Section: Introductionmentioning

confidence: 99%

“…A range of interventions can be employed including nasal packing, hormone therapies, monoclonal antibodies, local sclerotherapy, diathermy, and various coagulation and cautery techniques that often demonstrate at least short-term effectiveness. [5][6][7][8] Coagulation and cautery techniques have consistently shown benefit, but most patients experience a recurrence of their symptoms within 1-2 years. 5,7,8 Systemic pharmacological therapies, such as low-dose bevacizumab, have been explored in recent years with evidence of benefit for patients seeking a non-invasive treatment of severe epistaxis prior to considering surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

The effects of nasal closure on quality of life in patients with hereditary hemorrhagic telangiectasia

Thomson

Molin

Whitehead

et al. 2018

Laryngoscope Investig Oto

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IntroductionEpistaxis is the most common symptom of hereditary hemorrhagic telangiectasia (HHT). Complete nasal closure is one of the treatment options for patients with severe, intractable epistaxis. In our experience, this surgery can be life changing in a positive sense; but many patients as well as their physicians understandably fear that such a procedure will diminish certain aspects of quality of life (QOL).MethodsCase‐control study of HHT patients treated at the University of Utah HHT Center of Excellence with and without nasal closure from January 2005 to January 2016. Patients were matched according to epistaxis severity. Each included patient was issued three surveys: Epistaxis Severity Score (ESS), the Pittsburg Sleep Quality Index (PSQI), and the Nasal Obstruction Symptom Evaluation (NOSE).ResultsAfter treatment, the mean PSQI and NOSE scores were not significantly different between the two groups. However, the mean ESS score in the nasal closure group was significantly lower at 1.10 compared to the severe epistaxis group with a mean score of 3.99 (P = .027).ConclusionThe results of this study demonstrate that nasal closure significantly improves epistaxis severity without having a significant effect on sleep or nasal obstruction as they relate to QOL. These findings suggest that nasal closure should be considered for HHT patients with chronic severe epistaxis.Level of Evidence4.

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Argon plasma coagulation is an effective treatment for hereditary hemorrhagic telangiectasia patients with severe nosebleeds

Abstract: After APC treatment, a statistically significant decrease in all epistaxis parameters was recorded and most patients did not need blood transfusions for several years after the procedure.

Cited by 17 publications

References 18 publications

Evidence-based management of epistaxis in hereditary haemorrhagic telangiectasia

Evidence-based management of epistaxis in hereditary haemorrhagic telangiectasia

Sterilization Method Using Plasma Discharge Against Biofilm-Producing Pseudomonas aeruginosa on Surface of Contact Lens

The effects of nasal closure on quality of life in patients with hereditary hemorrhagic telangiectasia

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