Hereditary hemorrhagic telangiectasia treated by laser surgery

Hereditary hemorrhagic telangiectasia (Osler's disease) is a rare, inherited abnormality of the subepithelial vessels causing severe nose bleed as the most predominant symptom. The most efficient treatment has, until now, been dermoplasty of the nasal septum and cavity. There have been a few reports on treatment with CO2-, argon- or Nd-YAG-lasers, which have been encouraging. Ten patients with Osler's disease were treated for severe epistaxis. Three were treated with CO2-laser, two of these under general anaesthesia. Seven patients were treated with the argon laser under local anaesthesia. A variety of other sites were treated at the same time for functional or cosmetic reasons (mouth, face, fingers, rectum). Good results were obtained in eight cases. In three of the cases the observation period was more than two years. A second treatment has been necessary in three cases. Two other patients were treated recently, and it is too early to judge the results. The argon-laser is more convenient for this purpose than the CO2-laser. The method is quick and reliable and there is no need for hospitalization. The treatment can be repeated without permanent damage to the function of the nose.