Comparison of electrosurgical plasma coagulation and potassium‐titanyl‐phosphate laser photocoagulation for treatment of hereditary hemorrhagic telangiectasia‐related epistaxis

Luk, Lauren J.; Mace, Jess C.; Bhandarkar, Naveen D.; Sautter, Nathan B.

doi:10.1002/alr.21328

Cited by 25 publications

(21 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Few prospective randomized trials comparing treatments for recurrent epistaxis due to HHT have been reported. A recent trial comparing KTP laser treatment and electrosurgical plasma coagulation in 11 patients demonstrated equivalent 1‐year epistaxis control . Results of the North American Study of Epistaxis (NOSE Study)—comparing the safety and efficacy of 3 topical agents and nasal saline spray in 140 randomized patients—are highly anticipated.…”

Section: Discussionmentioning

confidence: 99%

Prospective randomized trial of sclerotherapy vs standard treatment for epistaxis due to hereditary hemorrhagic telangiectasia

Boyer

Fernandes

et al. 2015

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

Background Our previous studies have demonstrated the tolerability and low side-effect profile of office-based sclerotherapy with sodium tetradecyl sulfate (STS) for treating recurrent epistaxis due to hereditary hemorrhagic telangiectasia (HHT). The objective of this study was to use a prospective randomized trial to determine the effectiveness of sclerotherapy with STS vs standard treatment. Methods This prospective randomized trial (conducted from November 1, 2011, through January 31, 2014) involved 17 patients with recurrent epistaxis due to HHT. We defined standard treatment as continuation of any treatment that the patient had previously undergone, such as moisturization, packing, and cautery. We used a crossover design, so study participants were randomized to either sclerotherapy or standard treatment during the first time period, and then to the other during the second period. The primary outcome measure was frequency and severity of epistaxis, as measured by the epistaxis severity score (ESS). The ESS is a 10-point scale, with higher scores corresponding to more bleeding. Results After controlling for treatment order, bleeding was substantially better controlled after sclerotherapy; the ESS after sclerotherapy was nearly one point lower than after standard treatment (−0.95, 1-sided p = 0.027). Treatment order, baseline ESS, the number of lesions, moisturization practices, and a history of previous blood transfusions did not significantly affect the results. Conclusion This trial demonstrated that sclerotherapy with STS (vs standard treatment) significantly reduced epistaxis due to HHT.

show abstract

Section: Discussionmentioning

confidence: 99%

Prospective randomized trial of sclerotherapy vs standard treatment for epistaxis due to hereditary hemorrhagic telangiectasia

Boyer

Fernandes

et al. 2015

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

show abstract

“…Recommendation Both cutaneous and mucosal lesions may be treated by KTP (532 nm), millisecond Nd:YAG (1064 nm), diode (810 nm), LPDL (GRADE 1B), argon and carbon‐dioxide lasers (GRADE 1C) …”

Section: Treatment Of Different Vascular Lesionsmentioning

confidence: 99%

“…88 Recommendation 12: Both cutaneous and mucosal lesions may be treated by KTP (532 nm), millisecond Nd:YAG (1064 nm), diode (810 nm), LPDL (GRADE 1B), argon and carbon-dioxide lasers (GRADE 1C). 40,[89][90][91][92][93][94] Treatment may leave a small depression as large as the telangiectatic papule after the treatment. Intranasal injections of bevacizumab may be combined with the diode laser treatment.…”

Section: Treatment Of Different Vascular Lesionsmentioning

confidence: 99%

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology

Adamič¹,

Pavlović

Rubin

et al. 2015

Acad Dermatol Venereol

View full text Add to dashboard Cite

Aim Lasers and non-coherent intense pulse light sources (IPLS) are based on the principle of selective photothermolysis and can be used for the treatment of many vascular skin lesions. A variety of lasers has been developed for the treatment of congenital and acquired vascular lesions which incorporate these concepts into their design. Although laser and light sources are very popular due to their non-invasive nature, caution should be considered by practitioners and patients to avoid permanent side-effects. The aim of these guidelines is to give evidence-based recommendations for the use of lasers and IPLS in the treatment of vascular lesions. Results Lasers and IPLS are very useful and sometimes the only available method to treat various vascular lesions. It is of a paramount importance that the type of laser or IPLS and their specific parameters are adapted to the indication but also that the treating physician is familiar with the device to be used. The crucial issue in treating vascular lesions is to recognize the immediate end-point after laser treatment. This is the single most important factor to ensure both the efficacy of the treatment and avoidance of serious side-effects. Methods Conflicts of interestNone declared. Funding sourceNone.Since the publication of previous European Society of Laser Dermatology (ESLD) guidelines in 2007, there have been significant advances in the field of laser treatment of common vascular lesions.1 These guidelines have been updated by the Consensus Panel under the auspices of the ESLD. Methodology, search strategy and recommendation formulation are described in Appendix II. A brief overview of vascular lasersStandard vascular lasers include pulsed dye lasers (585 and 595 nm), and KTP-lasers (532 nm), followed by longer wavelength lasers such as alexandrite lasers (755 nm), diode lasers (800-900 nm) and millisecond Nd:YAG lasers (1064 nm). New developments include a non-uniform pulse sequence or a dual-wavelength modality (combined dual wavelength 595 and 1064 nm-pulsed dye and Nd:YAG laser) and microsecond Nd: YAG lasers. [2][3][4][5][6] Even fractional photothermolysis has begun to be used for selected vascular lesions. Lasers' and intense pulse light sources (IPLS) effects are based on the principle of selective photothermolysis. In general, they deliver a precisely graded aliquot of energy to a defined area of the skin in a reproducible, standardized manner that almost always involves addition or evacuation of heat. The greatestThe first two authors have contributed equally to the manuscript.

show abstract

“…Coblation (electrosurgical plasma coagulation) has been shown to be safe and effective, and was recently reported to have similar efficacy to laser in a small group of patients (98,99) . Submucosal bipolar radiofrequency causes submucosal sclerosis with preservation of the overlying mucosa, and a small pilot study showed a significant reduction in HHT-related epistaxis when applied to the nasal septum (100) .…”

Section: Other "Local" Surgical Treatmentsmentioning

confidence: 99%

Hereditary haemorrhagic telangiectasia

Rimmer

Lund

2015

Rhin

View full text Add to dashboard Cite

Background: Hereditary haemorrhagic telangiectasia is an autosomal dominant vascular disease characterized by recurrent epistaxis, mucocutaneous telangiectasia and visceral arteriovenous malformations. Methodology:The genetic basis and pathophysiology of the disease are discussed. Diagnostic criteria and the clinical course of the condition are considered. The current management options, both medical and surgical, are reviewed. Conclusions:Hereditary haemorrhagic telangiectasia requires specialist treatment for the problems it causes, and is best managed in specialist centres. Epistaxis is often the major symptom, significantly affecting patients' quality of life. An understanding of the available treatment options is therefore important for the otorhinolaryngologist.

show abstract

Comparison of electrosurgical plasma coagulation and potassium‐titanyl‐phosphate laser photocoagulation for treatment of hereditary hemorrhagic telangiectasia‐related epistaxis

Cited by 25 publications

References 19 publications

Prospective randomized trial of sclerotherapy vs standard treatment for epistaxis due to hereditary hemorrhagic telangiectasia

Prospective randomized trial of sclerotherapy vs standard treatment for epistaxis due to hereditary hemorrhagic telangiectasia

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology

Hereditary haemorrhagic telangiectasia

Contact Info

Product

Resources

About