title: Office-based sclerotherapy for recurrent epistaxis due to hereditary hemorrhagic telangiectasia: a pilot study.
abstract: BACKGROUND
  The aim of this pilot study is to evaluate office-based sclerotherapy using sodium tetradecyl sulfate (STS) for epistaxis due to hereditary hemorrhagic telangiectasias (HHT). Patients with HHT suffer from unpredictable, recurrent, severe nasal bleeding necessitating emergency care, nasal packing, blood transfusions, and invasive procedures.
  
  
  METHODS
  In this retrospective study 7 patients with a history of treatment for recurrent epistaxis due to HHT were treated in an office-based setting with intralesional injection of STS. Treatment results were evaluated using a questionnaire. All patients had undergone multiple prior procedures attempting to control epistaxis.
  
  
  RESULTS
  Patients had an average of 5 sclerotherapy treatments for HHT. Patients were treated using topical and/or local anesthesia with no reports of discomfort. Bleeding requiring intervention did not occur during the procedures. After the procedure all patients (100%) reported significantly less frequent and less severe nasal bleeding. A total of 83% reported that their need for nasal packing was reduced. All patients were willing to undergo the same treatment again. No complications such as perforation, crusting, or foul smell were reported.
  
  
  CONCLUSIONS
  This is the first clinical experience demonstrating that office-based sclerotherapy with STS is a safe, tolerable, and useful alternative for the treatment of epistaxis due to HHT.
authors.affiliation: Department of Otolaryngology/Head & Neck Surgery, University of Minnesota, Minneapolis, MN, USA. boyer011@umn.edu
authors.forename: Holly
authors.initials: H
authors.lastname: Boyer
authors.forename: Patricia
authors.initials: P
authors.lastname: Fernandes
authors.forename: Olga
authors.initials: O
authors.lastname: Duran
authors.forename: David
authors.initials: D
authors.lastname: Hunter
authors.forename: George
authors.initials: G
authors.lastname: Goding
mesh_terms: D000553:Ambulatory Care; D004844:Epistaxis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D012008:Recurrence; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods; D012981:Sodium Tetradecyl Sulfate / Q000627:therapeutic use*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate