[Argon plasma coagulation and topically applied estriol. Long-term results in the treatment of hereditary hemorrhagic telangiectasia of the nasal mucosa].
OBJECTIVE
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant fibrovascular dysplasia with the main symptom of recurrent epistaxis. At present, only limited data are available on long-term results in the treatment of epistaxis. A part from the surgical treatment of the bleeding telangiectasia with argon plasma, an additional postoperative long-term treatment with estriol nose-ointment was performed and the results were analysed.


METHODS
69 patients with HHT were treated with APC and estriol nose ointment. 43 patients could be examined over a follow-up period of more than 20 months. The bleeding frequency and intensity as well as the patient's satisfaction with the treatment result were evaluated and the serum estriol level determined.


RESULTS
After more than 20 months, the bleeding frequency and intensity were reduced in 95% of the patients compared to their preoperative findings. Under the influence of estriol, former berry-like telangiectasias became flatter and more even. Neither systemic side effects under topically applied estriol nor a relevant increase of serum estriol levels were observed.


CONCLUSIONS
The combined treatment regimen with APC and topically applied estriol provides a new treatment concept of epistaxis in HHT.
Sadick
H
H
Universitäts-Hals-Nasen-Ohren-Klinik Mannheim. Hannen.sadick@hno.ma.uni-heifdelberg.de
Riedel
F
F
Oulmi
J
J
Hörmann
K
K
Bergler
W F
WF
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003131:Combined Modality Therapy; D004844:Epistaxis / Q000235:genetics / Q000628:therapy*; D004964:Estriol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000098:blood supply*; D017060:Patient Satisfaction; D011182:Postoperative Care; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000235:genetics / Q000628:therapy*
D004964:Estriol