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Resurfacing Endoscopic Free Flap for Hereditary Hemorrhagic Telangiectasia
Thorsen W Haugen1, Randy W Lesh1, Vincent M Desiato1
1Department of Otolaryngology - Head and Neck Surgery, Geisinger Health System, Danville, Pennsylvania, USA.
Background:
Epistaxis related to hereditary hemorrhagic telangiectasia (HHT) can be life-threatening and decreases quality of life (QoL). Current medical and surgical options are limited, particularly in the advanced stages of the disease.
Methods:
We assess the feasibility and outcome of HHT-related epistaxis management by resurfacing the nasal cavity with an endoscopically placed free flap. The Epistaxis Severity Score (ESS) was compared to the preoperative score at one-year post-surgery.
Results:
The nasal cavity was successfully resurfaced with a radial forearm free flap. The ESS decreased from 8.9 to 3.5 one-year postoperatively.
Conclusion:
Resurfacing endoscopic free flap (REFF) is a safe and effective procedure for the management of HHT-related epistaxis refractory to other treatment options. Nasal function is maintained, with a significant long-term decrease in epistaxis.
