[Nd:YAG laser therapy of recurrent epistaxis in hereditary hemorrhagic telangiectasia].
BACKGROUND
Epistaxis is the leading symptom of hereditary hemorrhagic teleangiectasia (HHT). Over the last years several laser systems have been used for therapy. Only a few studies have published results of Nd:YAG laser therapy evaluating a larger number of patients.


METHODS
From 1987 through 1996, forty-one patients with HHT were treated with a Nd:YAG laser due to recurrent epistaxis at the Department of Otorhinolaryngology of Kiel University. Thirty-two patients were followed-up over a period of at least 24 months. A centripetal technique was used for endonasal laser light application (15-25 Watts; 0.1-0.5 s), i.e., the laser light was applied from the periphery towards the center of the angiodysplasia. Intensive preoperative and postoperative nasal care with ointments was performed.


RESULTS
Bleeding frequency and intensity decreased in 30 (94%) patients. Duration of the therapeutical success differed individually and varied from seven weeks to 14 months. Repeated laser therapy was necessary in 27 of 32 patients.


CONCLUSIONS
The Nd:YAG laser is a suitable tool in the treatment of epistaxis in HHT. This procedure is less traumatic, less painful, and can be repeated multiple times. Nd:YAG laser therapy and other therapeutic options cannot obtain a lasting cure of Rendu-Osler-Weber syndrome. However, in the vast majority of cases recurrent nasal bleeding as the dominant symptom can be reduced in frequency as well as in intensity.
Werner
J A
JA
Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie der Universität Kiel.
Lippert
B M
BM
Geisthoff
U W
UW
Rudert
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000175:diagnosis / Q000601:surgery*