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

Thomson, Rhett S.; Molin, Nicole; Whitehead, Kevin J.; Ashby, Shaelene; Johnson, Leland P.; Ward, P. Daniel; McRae, Bryan R.; Wilson, Kevin F.; McDonald, Jamie

doi:10.1002/lio2.157

Cited by 10 publications

(16 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Karapantzos et al reported that 27 HHT patients who were treated with Nd:YAG laser showed improved scores in several dimensions of SF‐36, 2 years postoperatively. Other studies have shown improved HR‐QoL in HHT patients who underwent nasal closure, while patients treated with argon laser, and a combination of septodermoplasty and argon laser showed no significant improvement …”

Section: Discussionmentioning

confidence: 89%

Intranasal bevacizumab injections improve quality of life in HHT patients

et al. 2019

View full text Add to dashboard Cite

Background: Epistaxis is the most common symptom in patients with hereditary hemorrhagic telangiectasia (HHT), with the greatest negative impact on quality of life (QoL). Repeated intranasal submucosal bevacizumab injections (RISBI) is a relatively new treatment option for moderate or severe grades of epistaxis in HHT. However, the effect of RISBI on QoL is not fully evaluated.Study Design: Prospective, non-comparative study. Materials and Methods: Patients treated by RISBI for HHT-associated epistaxis between June 2011 and August 2013 were prospectively invited to the present study. The end of follow-up was October 2013. The patients were requested to answer QoL questionnaires before the first treatment, and 6-8 weeks after the last treatment. Three levels of QoL were assessed: Overall QoL using Cantril's Self-Anchoring Ladder; Health-related QoL using Short Form 36 (SF-36), and Disease-specific QoL. Psychological distress was measured with the Hospital Anxiety and Depression scale (HADS).Results: Thirty-three patients were treated with RISBI during the period referred to above. Twenty-three patients completed the QoL questionnaires. The average number of treatments per patient was 2.15 AE 1.3 (Range: 1-5). The mean overall QoL improved from 6.47 AE 1.9 to 7.26 AE 1.6 (P < .05). Several dimensions measured by SF-36 were significantly improved with a medium to strong effect size. HADS demonstrated a significant decrease in psychological distress after the last treatment.Conclusion: HHT patients treated by RISBI improved in several aspects of quality of life, and psychological distress decreased. RISBI was an effective treatment option for moderate and severe grades of HHT-associated epistaxis.

show abstract

Section: Discussionmentioning

confidence: 89%

Intranasal bevacizumab injections improve quality of life in HHT patients

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The risks and benefits should be weighed carefully, especially in patients with HHT. If recurrent epistaxis cannot be controlled conservatively, surgical interventions like nasal occlusion should be considered in an experienced center [ 35 ]. Long-term use of TXA in HHT patients could possibly further damage already strained nasal mucosa and consequently lead to biofilm formation with bacterial colonization, chronic inflammation and nasal congestion.…”

Section: Discussionmentioning

confidence: 99%

Effects of tranexamic acid on human nasal ciliary beat frequency

Behr

Horschke

Nastev

et al. 2021

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Background Patients with recurrent epistaxis, particularly due to hereditary hemorrhagic telangiectasia (HHT) are recommended to apply topical tranexamic acid (TXA) to reduce bleeding events. Those patients may suffer ciliary dysfunction due to TXA’s effects on ciliary beating frequency (CBF) and their consequences. Methodology/principal Human nasal epithelial cells were harvested with a nasal brush in 30 healthy subjects. We investigated the CBF in RPMI medium using high-frequency video microscopy. TXA was added to the cells in various concentrations ranging from 2 to 5%, including the therapeutic concentration (2%) and a control (0%). Results CBF in the control condition was 6.1 ± 1.6 Hz. TXA reduces CBF in a time and concentration dependent manner, to, e.g. 4.3 ± 1.2 Hz with 2% TXA and 3.3 ± 0.9 Hz with 5% TXA after 16–20 min. The differences in CBF were statistically significant for all concentrations of TXA. Conclusions TXA has the potential to significantly impair nasal epithelial function. Therefore, frequent or regular topical nasal application of TXA should be done under close monitoring of nasal function, especially in patients with co-morbidities like chronic rhinosinusitis.

show abstract

“…Our study does not highlight changes in the quality of life followed by nasal closure, but pictures a substantial improvement in general health and reduction in epistaxis and daily bleedings. Previous studies have linked reduced epistaxis to increase the quality of life (QOL), using epistaxis severity score (ESS) as a   surrogate measure for QOL [19,20]. As of 2018, each HHT center has its own criteria for selecting patients for nasal closure.…”

Section: Discussionmentioning

confidence: 99%