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Nasal dermoplasty for Japanese hereditary hemorrhagic telangiectasia
Keiichi Ichimura1, Hidetaka Tanaka, Yoshinori Yamamoto
1Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan. k-ichi@jichi.ac.jp
Objective:
While generally considered an effective treatment for moderate to severe epistaxis in hereditary hemorrhagic telangiectasia (HHT), nasal dermoplasty (ND) has not been well established in Japan. This prompted the present Japanese assessment of clinical efficacy and patient satisfaction following this procedure.
Methods:
Retrospective analysis of clinical records of 15 patients with HHT undergoing ND between August 1991 and May 2004 and survey of these patients as to postsurgical conditions. Main outcome measures were skin graft "take" frequency after surgery (all patients), reported patient satisfaction (eight recent patients), and reported volume and frequency of epistaxis after versus before surgery (eight recent patients).
Results:
Graft take rate was 100%. Most patients experienced reduced frequency and volume of bleeding. One patient required an additional operation, total closure of the external nares, 2 years later. Overall patients felt satisfied with ND, experiencing less nasal obstruction than expected.
Conclusions:
ND is effective in Japanese patients with moderate and severe nasal bleeding from HHT, reducing their risk of bleeding.
