title: Avastin and diode laser: a combined modality in managing epistaxis in hereditary hemorrhagic telangiectasia.
abstract: A patient with hereditary hemorrhagic telangiectasia is a rare presentation to the otolaryngologist in clinical practice. They almost present with epistaxis, which is recurrent, spontaneous and can be functionally and socially debilitating for the patient. Diode laser cauterization and Avastin intranasal injection showed significant improvement in epistaxis severity score. We report a case of hereditary hemorrhagic telangiectasia with chronic epistaxis (hemoglobin 3.4 mg/dl) managed with Diode laser and intranasal Avastin injection with great improvement in life quality and decrease in epistaxis attacks. Despite all treatment options absolute eradication of epistaxis attacks is difficult to obtain in these cases.
authors.affiliation: Faculty of medicine in Umm Alqura university at Makkah, Saudi Arabia.
authors.forename: Osama A
authors.initials: OA
authors.lastname: Marglani
authors.forename: Naif A
authors.initials: NA
authors.lastname: Bawazeer
authors.forename: Omar A
authors.initials: OA
authors.lastname: Abu Suliman
mesh_terms: D000281:Administration, Intranasal; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D004844:Epistaxis / Q000209:etiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab