[Current treatment of Rendu-Osler disease, excluding radiation]

All the methods available to O.-R.-L. practitioners for the treatment of epistaxis in Rendu-Osler disease are reviewed. In an emergency, gentleness is essential. Over the long term, procrastination for as long as possible is advisable. Super-selective arteriography and embolization are of great value in an emergency and can give some good long-term results. In fact, there is not one exclusive curative therapy. Estrogenotherapy has its advocates. Saunder's dermoplasty gives variable results, but these can be improved upon if a broad access route is used and dermoplasty extended to above and behind the nasal fossae. Because of its aggressive nature, irradiation must be kept as a last resort.