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Intractable epistaxis due to isolated primary telangiectasias
Timothy Stoddard1, Todd A Loehrl1, Bryan C Hunt2
1Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee.
JAMA Otolaryngology-- Head & Neck Surgery
|December 17, 2013
Summary
Intractable epistaxis from isolated telangiectasias, previously unreported, can be effectively treated with bipolar electrosurgery. This less invasive method offers a successful alternative to traditional interventions for nasal bleeding.
Area of Science:
- Otolaryngology
- Vascular Medicine
Background:
- Epistaxis is a common otolaryngologic emergency.
- Intractable epistaxis often requires advanced interventions like nasal packing or surgery.
- Nasal telangiectasias are known causes of bleeding in hereditary hemorrhagic telangiectasia, but not as isolated primary lesions.
Purpose of the Study:
- To report on intractable epistaxis caused by isolated primary telangiectasias.
- To evaluate the efficacy of bipolar electrosurgery for treating this condition.
Main Methods:
- A case series of 16 adult patients with epistaxis (6 intractable) treated between 2009-2012.
- Endoscopic identification of telangiectasias as the bleeding source.
- Treatment with bipolar electrosurgery.
Main Results:
- Telangiectasias were identified as the source of bleeding in various nasal locations.
- Bipolar electrosurgery successfully controlled intractable epistaxis in the studied cases.
- This treatment avoided more invasive surgical or endovascular procedures.
Conclusions:
- Isolated primary telangiectasias are an unreported cause of significant nasal bleeding.
- Endoscopic identification and bipolar electrosurgery provide an effective treatment.
- This approach is less invasive and potentially less costly than traditional methods.
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