[Treatments of hereditary hemorrhagic telangiectasia of the nasal mucosa].
Hereditary Hemorrhagic Telangiectasia is a systemic autosomal dominant disorder involving blood vessels. The most common symptom is recurrent epistaxis. The treatments of these epistaxis are numerous but such treatments are often symptomatic and their effects are often not sustained. Some of these treatments may be complicated by visceral vascular malformations. The aim of this study is to propose a treatment plan for these patients with hierarchical organisation of therapeutic options taking into account of their previous therapy.


METHODS
H. Plauchu organized in Paris, december 2002 a meeting with any medical specialists of this disease. They have analysed variety of therapies that have been proposed for epistaxis control in Hereditary Haemorrhagic Télangiectasia.


RESULTS
Most common use packing of nasal fossa and then hyperselective embolization of the internal maxillary and facial arteries for severe epistaxis. For chronic epistaxis, best treatment use sclerotics products (Ethibloc) and laser. After discussion, primary embolization could be useful to reduce vascularization of nasal fossa.


CONCLUSIONS
Treatment of epistaxis in Hereditary Haemorrhagic Telangiectasia could increase in few years. Use of an index card of for epistaxis in the disease of Rendu-Osler could help to find treatment of choice.
Babin
E
E
CHU, Service ORL et de Chirurgie Cervico-Faciale, Avenue de la Côte de Nacre, F-14033 Caen Cedex 1, France. babin-e@chu-caen.fr
Borsik
M
M
Braccard
S
S
Crampette
L
L
Darrouzet
V
V
Faure
F
F
Fontanel
J P
JP
Houdart
E
E
Jankowski
R
R
Le Clech
G
G
Malvezzi
L
L
Morinière
S
S
Perie
S
S
Perret
J
J
Pignat
J C
JC
Portier
F
F
Serrano
E
E
Plauchu
H
H
D000208:Acute Disease; D002908:Chronic Disease; D004621:Embolization, Therapeutic; D004844:Epistaxis / Q000628:therapy*; D006801:Humans; D017075:Laser Coagulation; D008438:Maxillary Artery; D009297:Nasal Mucosa / Q000098:blood supply; D010347:Patient Care Planning; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy; D013630:Tampons, Surgical; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000628:therapy*
D012597:Sclerosing Solutions