title: [Nasal cavity dermoplasty as a treatment of recurrent bleeding in Rendu-Osler-Weber's disease].
abstract: BACKGROUND
  Rendu-Osler-Weber's (ROW) disease is a systemic disorder of blood vessels classified as a capillary malformation. The most common manifestation of hereditary hemorrhagic teleangiectasia is recurrent epistaxis. The diagnosis of ROW disease is made clinically using the Curacao criteria. Management of epistaxis is usually difficult and many types of treatment have been described.
  
  
  METHODS
  We report 12 patients, 7 female and 5 male, aged 52 to 78 with ROW disease and recurrent epistaxis with frequency varying from 5 episodes monthly to 3 - 5 episodes daily. In most of them blood transfusion was required. The patients were treated with intranasal dermoplasty described by Saunders. The dermoplasty was performed on the septal, lateral or both walls of the anterior part of the nasal cavities.
  
  
  RESULTS
  In all the patients the graft was taken completely. Two patients had scars and narrowing of nasal valve region. Recurrence and increase in the intensity of nasal bleeding were observed in 3 patients. In the course of further therapy the second partial septal dermoplasty was successfully performed in 2 of them. The second surgery revealed new bleeding teleangiectases beyond of the dermal graft.
  
  
  CONCLUSIONS
  Nasal cavity dermoplasty remains an effective way of reducing epistaxis and blood transfusion in patients with ROW disease and subjectively improves their quality of life. The surgical treatment can be repeated, if nasal bleeding recur.
authors.affiliation: Katedra i Klinika Otolaryngologii i Onkologii Laryngologicznej AM w Lublinie.
authors.forename: Adam
authors.initials: A
authors.lastname: Kłos
authors.forename: Wiesław
authors.initials: W
authors.lastname: Golqbek
authors.forename: Kamal
authors.initials: K
authors.lastname: Morshed
mesh_terms: D000368:Aged; D004564:Electrocoagulation; D004724:Endoscopy; D004844:Epistaxis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery*; D013524:Surgical Flaps; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome