title: Topical estrogens combined with argon plasma coagulation in the management of epistaxis in hereditary hemorrhagic telangiectasia.
abstract: The aim of this study was to assess the value of topically applied estrogens in patients with hereditary hemorrhagic telangiectasia. Twenty-six patients with this disorder were treated with argon plasma coagulation and randomized into 2 groups: group A, which had postoperative application of estriol ointment (n = 14), and group B, which had postoperative application of dexpanthenol ointment (n = 12). Over a period of 12 months, the frequency and intensity of bleeding, the patient's satisfaction, and the success of the treatment were evaluated with a questionnaire. Before the operation, more than 90% of the patients in both groups complained of daily episodes of epistaxis. Twelve months after treatment, the frequency and intensity of bleeding had significantly decreased in group A as compared to group B. Of the patients in group A, 93% were satisfied with the treatment. Of the patients in group B, only 42% were satisfied with the treatment. In both groups, more than 90% of the patients were willing to undergo the same treatment again. The combined treatment approach with argon plasma coagulation and topical estriol enables us to significantly prolong the hemorrhage-free interval.
authors.affiliation: From the Department of Otolaryngology-Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Bergler
authors.forename: Haneen
authors.initials: H
authors.lastname: Sadick
authors.forename: Karl
authors.initials: K
authors.lastname: Gotte
authors.forename: Frank
authors.initials: F
authors.lastname: Riedel
authors.forename: Karl
authors.initials: K
authors.lastname: Hörmann
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000368:Aged; D001128:Argon; D017024:Chemotherapy, Adjuvant; D002648:Child; D016903:Drug Monitoring; D004844:Epistaxis / Q000097:blood / Q000453:epidemiology / Q000235:genetics* / Q000628:therapy*; D004964:Estriol / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D017075:Laser Coagulation / Q000295:instrumentation / Q000379:methods* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010205:Pantothenic Acid / Q000008:administration & dosage* / Q000031:analogs & derivatives; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D009824:Ointments; D010205:Pantothenic Acid; C007288:dexpanthenol; D001128:Argon; D004964:Estriol