Coblation for epistaxis management in patients with hereditary haemorrhagic telangiectasia: a multicentre case series

Joshi, Himani; Woodworth, Bradford A.; Carney, A. Simon

doi:10.1017/s0022215111001733

Cited by 31 publications

(29 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…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. 3,8,11,12 The group of treatments that decrease the blood flow includes nasal packing, angiographic embolization and arterial ligation.…”

Section: 49mentioning

confidence: 99%

“…These symptoms are usually not well tolerated by patients. [9][10][11][12] Most of the nasal ointments used have a lipid base, as the effect appears to be longer than aqueous base preparations. They turn the nasal cavity into a moist chamber, which has a positive impact on the frequency of epistaxis.…”

mentioning

confidence: 99%

“…Septodermoplasty (Saunders' procedure), involves the replacement of the anterior part of the septal mucosa (with preservation of the underlying perichondrium) by a free skin graft. 1,9,11,12 Although this method allows an initial symptomatic improvement, the effect is lost throughout the years due to the contraction and revascularization of the graft with formation of new telangiectasia.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Radiofrequency for Treatment of Refractory Epistaxis in Hereditary Hemorrhagic Telangiectasia

et al. 2018

View full text Add to dashboard Cite

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.

show abstract

Section: 49mentioning

confidence: 99%

Section: 49mentioning

confidence: 99%

Section: 49mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Radiofrequency for Treatment of Refractory Epistaxis in Hereditary Hemorrhagic Telangiectasia

et al. 2018

View full text Add to dashboard Cite

show abstract

Management of severe epistaxis after Young's procedure: a case report

Ting

Remenschneider

Holbrook

2012

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

show abstract

Injection of bevacizumab and cyanoacrylate glue for hereditary hemorrhagic telangiectasia

Khoueir

Borsik²,

Camous³

et al. 2019

The Laryngoscope

View full text Add to dashboard Cite

Objectives/Hypothesis The objective of this study was to report for the first time on the results of submucosal injections of bevacizumab used in conjunction with cyanoacrylate glue sclerotherapy in hereditary hemorrhagic telangiectasia (HHT). Study Design Retrospective analytic chart review. Methods We performed a chart review that included all patients with HHT treated with intranasal bevacizumab and cyanoacrylate glue for refractory epistaxis at Lariboisiere University Hospital from 2013 with a minimum follow‐up of 6 months. We injected 100 mg (25 mg/mL) of bevacizumab diluted in 2 mL of serum at the base of the telangiectasias, and sclerotherapy with an injection of cyanoacrylate glue was used adjunctively. Treatment efficacy was based on changes in Epistaxis Severity Scores (ESS) and the Bergler‐Sadick Scale. Quality of life and patient satisfaction were evaluated using the Cantril Self‐Anchoring Ladder (CL) and Likert scale, respectively. Results Thirty‐one patients were included, with a mean follow‐up of 26.6 months. The average ESS score significantly decreased from 7.82 to 3.89 (P < .05). The Bergler‐Sadick score significantly improved (P < .05) following the treatment, including the frequency (from 2.74 to 1.64) and the quantity (from 2.54 to 1.51) scales. Quality of life was significantly improved (P < .05) using the CL score (from 4.16 to 7.22). The Likert satisfaction scale related to the treatment efficacy was high, with an average of 7.03 out of 10. No complications were noted. Conclusions Submucosal injections of bevacizumab in conjunction with cyanoacrylate glue sclerotherapy significantly reduced epistaxis and improved the quality of life in HHT. Prospective comparative studies are needed to further evaluate the significance of this treatment modality. Level of Evidence 3b Laryngoscope, 129:2210–2215, 2019

show abstract

Coblation for epistaxis management in patients with hereditary haemorrhagic telangiectasia: a multicentre case series

Abstract: Radiofrequency coblation is a novel technique, which was found to be a safe, effective, quick and well tolerated treatment option for epistaxis management in patients with hereditary haemorrhagic telangiectasia.

Cited by 31 publications

References 23 publications

Radiofrequency for Treatment of Refractory Epistaxis in Hereditary Hemorrhagic Telangiectasia

Radiofrequency for Treatment of Refractory Epistaxis in Hereditary Hemorrhagic Telangiectasia

Management of severe epistaxis after Young's procedure: a case report

Injection of bevacizumab and cyanoacrylate glue for hereditary hemorrhagic telangiectasia

Contact Info

Product

Resources

About