Argon plasma coagulation is an effective treatment for hereditary hemorrhagic telangiectasia patients with severe nosebleeds.
CONCLUSIONS
In contrast to the current trend according to which the treatment of hereditary hemorrhagic telangiectasia (HHT) epistaxis depends on clinical severity, argon plasma coagulation (APC) has also proven to be effective as a first-line procedure in patients with severe nosebleeds. Furthermore, with this approach patients are free from requirements for blood transfusions for a long time in the vast majority of cases.


OBJECTIVE
The aim of this study was to test the efficacy of APC treatment as a first-line procedure in HHT patients affected by severe epistaxis.


METHODS
From 1996 until 2011, 252 HHT patients were treated with APC in our clinic. We selected 26 patients with severe epistaxis for whom the need for blood transfusion had been recorded. This group of patients was asked to answer a questionnaire that aimed to evaluate the severity of epistaxis (defined by its intensity, frequency, and duration), to assess the duration of the benefit of treatment and to evaluate the number of blood transfusions required before and after treatment.


RESULTS
After APC treatment, a statistically significant decrease in all epistaxis parameters was recorded and most patients did not need blood transfusions for several years after the procedure.
Department of Otorhinolaryngology, University of Pavia and Foundation IRCCS Policlinico San Matteo, Pavia, Italy. tpagella@libero.it
Fabio
F
Pagella
Elina
E
Matti
Francesco
F
Chu
Alessandro
A
Pusateri
Carmine
C
Tinelli
Carla
C
Olivieri
Cecilia
C
Canzonieri
Laura
L
Boeri
Federica
F
Ornati
Cesare
C
Danesino
D000293:Adolescent; D000328:Adult; D057908:Argon Plasma Coagulation / Q000379:methods*; D002648:Child; D004844:Epistaxis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult