title: Technique modifications for septodermoplasty: an illustrative case.
abstract: BACKGROUND
  Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease that results in telangiectasia of the sinonasal tract, gastro-intestinal tract as well as possible arteriovenous malformations of the lung, liver and brain. One of the most common disease manifestations of HHT is epistaxis. Severe recurrent epistaxis necessitating iron therapy and blood transfusion is often managed with septodermoplasty. Its initial description was as an open surgical technique requiring nasal packing.
  
  
  METHODS
  We describe a modified approach to septodermoplasty done completely endoscopically and without nasal packing for a patient with severe epistaxis due to HHT.
  
  
  CONCLUSIONS
  The described technique modifications for the presented case allowed for same day discharge following surgery, complete take of the skin graft and resultant epistaxis control that ended thepatient's transfusion dependency. The merits of these modifications should be further evaluated in a clinical trial.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, The Ottawa Hospital, 737 Parkdale Ave., Room 459, Ottawa, ON, K1Y 1J8, Canada. mbastianelli@toh.on.ca.
authors.forename: Mark
authors.initials: M
authors.lastname: Bastianelli
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, The Ottawa Hospital, 737 Parkdale Ave., Room 459, Ottawa, ON, K1Y 1J8, Canada. kiltysj@gmail.com.|Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada. kiltysj@gmail.com.
authors.forename: Shaun J
authors.initials: SJ
authors.lastname: Kilty
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004724:Endoscopy / Q000379:methods*; D004844:Epistaxis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009297:Nasal Mucosa / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016038:Skin Transplantation / Q000379:methods*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome