Pilot study of submucosal radiofrequency for epistaxis in hereditary hemorrhagic telangiectasia

Mortuaire, G.; Boute, Odile; Py, Hatron; Chevalier, D.

doi:10.4193/rhin13.027

Cited by 21 publications

(17 citation statements)

References 16 publications

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“…[2][3][4]7,10,11 The most widely used treatments can be divided into four major groups: elimination of telangiectasia, reduction of blood flow, reduction of trauma and improvement of protection. 9 The first group includes laser ablation, argon plasma coagulation and radiofrequency.…”

Section: Discussionmentioning

confidence: 99%

“…3,11,12 In this case report, the surgical procedure was performed under general anesthetic with an endonasal endoscopic approach. The radiofrequency wand (Evac70 ® Ultra Xtra in coagulation mode) was applied directly on the nasal mucosa, vaporizing and controlling the bleeding areas.…”

Section: 49mentioning

confidence: 99%

“…Unlike laser or the standard electrocautery devices, radiofrequency works at low temperatures (between 40ºC -70ºC), thereby causing less thermal injury to adjacent tissues and minimizing the risk of septal perforation. 3,8,12 Theoretically, it also reduces the amount of crusting and scarring. 12 The use of radiofrequency for HHT epistaxis is a much more conservative procedure than laser and can be safely repeated without significant complications.…”

Section: 49mentioning

confidence: 99%

“…It is a disease with equal gender prevalence and has its highest prevalence in Curacao Island (Netherlands Antilles) in the southern Caribbean. [1][2][3][4][5][6][7][8] The Curacao criteria establish a definite diagnosis of HHT when three of the following four manifestations are found: recurrent epistaxis, mucocutaneous telangiectasia, arteriovenous malformations and positive family history. 2,4,5 Epistaxis is the most common and earliest symptom.…”

Section: Introductionmentioning

confidence: 99%

“…1,4,10,11 Although there is no definitive treatment, various treatments for epistaxis in HHT have been proposed. [2][3][4]7,10,11 This paper reports a case of a patient with HHT, in which an episode of refractory epistaxis was successfully treated with radiofrequency.…”

Section: Introductionmentioning

confidence: 99%

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Radiofrequency for Treatment of Refractory Epistaxis in Hereditary Hemorrhagic Telangiectasia

et al. 2018

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Hereditary hemorrhagic telangiectasia is a rare multi-systemic autosomal dominant disorder characterized by dysplasia of the vascular connective tissue and recurrent bleeding tendency. Epistaxis is the most common and earliest symptom. It is usually mild to moderate, however, in some patients it can be severe with significant interference in quality of life. We report a case of a patient with hereditary hemorrhagic telangiectasia, in which an episode of refractory epistaxis was treated with radiofrequency and fibrin sealant. Control of acute bleeding and elimination of telangiectasia was possible with this technique. After six months follow-up, there was no epistaxis recurrence. Various treatments for epistaxis in this disease have been described in the literature, but there is no consensus about the gold-standard procedure. Radiofrequency ablation of telangiectasia is a recent technique that has shown to be safe, effective and well tolerated, even in patients who underwent other previous treatments. Keywords: Epistaxis; Radiofrequency; Telangiectasia, Hereditary Hemorrhagic RESUMO A telangiectasia hemorrágica hereditária é uma doença autossómica dominante, multissistémica e rara, caracterizada pela displasia do tecido conectivo vascular com tendência à hemorragia recorrente. O sintoma mais comum e precoce é a epistaxis. Habitualmente é ligeira a moderada, no entanto, em alguns doentes, pode ser severa com interferência significativa na sua qualidade de vida. É reportado o caso de um doente com telangiectasia hemorrágica hereditária, em que um episódio de epistaxis refractária foi tratado com radiofrequência e um quelante de fibrina. Com esta técnica foi conseguido não só o controlo da hemorragia activa, mas também a eliminação das telangiectasias. Após seis meses de seguimento, não houve recorrência da epistaxis. Há vários tratamentos descritos na literatura para a epistaxis nesta doença, não havendo no entanto, consenso acerca do gold standard. A ablação com radiofrequência das telangiectasias é uma técnica recente que se tem mostrado segura, eficaz e bem tolerada, mesmo em doentes submetidos previamente a outros tratamentos.

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Section: Discussionmentioning

confidence: 99%

Section: 49mentioning

confidence: 99%

Section: 49mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Radiofrequency for Treatment of Refractory Epistaxis in Hereditary Hemorrhagic Telangiectasia

et al. 2018

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Recommandation de la SFORL (version courte). Prise en charge spécifique des épistaxis dans le cadre d’une maladie de Rendu-Osler

Robard

Michel

Escabasse

et al. 2017

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Ce

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Guidelines of the French Society of Otorhinolaryngology (SFORL) (short version). Specific treatment of epistaxis in Rendu-Osler-Weber disease

Malard

Crampette²,

Achache³

et al. 2017

European Annals of Otorhinolaryngology, Head and Neck Diseases

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Rendu-Osler-Weber disease is diagnosed from the presence of at least three of Curaçao's four criteria. In acute epistaxis, bidigital compression is recommended. Embolization is reserved for resistant epistaxis. Non-resorbable nasal packing and cauterization are contraindicated. Patient education is essential. Telangiectasia of the nasal mucosa can be treated by various local means. In the event of insufficient control, systemic administration of tranexamic acid is recommended.

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Pilot study of submucosal radiofrequency for epistaxis in hereditary hemorrhagic telangiectasia

Abstract: Submucosal RF treatment for HHT is a safe, well tolerated procedure with significant efficacy in the short term. It should be considered as an alternative technique for managing HHT-related epistaxis, although long-term results remain to be evaluated.

Cited by 21 publications

References 16 publications

Radiofrequency for Treatment of Refractory Epistaxis in Hereditary Hemorrhagic Telangiectasia

Radiofrequency for Treatment of Refractory Epistaxis in Hereditary Hemorrhagic Telangiectasia

Recommandation de la SFORL (version courte). Prise en charge spécifique des épistaxis dans le cadre d’une maladie de Rendu-Osler

Guidelines of the French Society of Otorhinolaryngology (SFORL) (short version). Specific treatment of epistaxis in Rendu-Osler-Weber disease

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