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Treatment of hereditary haemorrhagic telangiectasia by the pulsed dye laser

Published online by Cambridge University Press:  29 June 2007

P. G. Harries*
Affiliation:
Department of Otolaryngology, Salisbury Healthcare NHS Trust, Salisbury District Hospital, Salisbury, UK
M. J. Brockbank
Affiliation:
Department of Otolaryngology, Salisbury Healthcare NHS Trust, Salisbury District Hospital, Salisbury, UK
P. G. Shakespeare
Affiliation:
Department of Laing Laboratory, Salisbury Healthcare NHS Trust, Salisbury District Hospital, Salisbury, UK
J. A. S. Carruth
Affiliation:
Department of Laser Unit, Salisbury Healthcare NHS Trust, Salisbury District Hospital, Salisbury, UK
*
Address for correspondence: Mr. P. G. Harries, The Coach House, Mill Road, Slindon Common, Arundel, West Sussex BN18 OLY

Abstract

Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome, Osier's disease) is an inherited abnormality of the vasculature characterized by abnormal subepithelial vessels. Treatment has included repeated intranasal cautery, intra-arterial embolization and arterial ligation.

Treatment has included repeated intranasal cautery, intra-arterial embolization and arterial ligation. Historically, the operation of septodermoplasty and the use of systemic/topical oestrogens have been the most effective and lasting treatments, but over time the telangiectasias recur. There is increasing interest in the use of a variety of lasers for intranasal photocoagulation.

A report of nine patients suffering from hereditary haemorrhagic telangiectasia who have undergone laser treatment with the Chromos pulsed dye laser is presented. This laser produces light energy at a wavelength of 585 nm and causes localized thermal damage to the blood vessel wall.

Initially, no patient saw an improvement in their symptoms, but following an average of approximately three courses of treatment, all have reported a measurable reduction in the number of epistaxes suffered.

Although no treatment completely resolves the epistaxis associated with this condition, we have found the pulsed dye laser to be effective at treating telangiectasias within the anterior nasal cavity.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1997

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References

Babington, B. G. (1865) Hereditary epistaxis (Letter). Lancet 2: 362363.Google Scholar
Ben-Bassat, M., Kaplan, M. B., Levy, R. (1978) Treatment of hereditary hemorrhagic telangiectasia of the nasal mucosa with the carbon dioxide laser. British Journal of Plastic Surgery 31: 157158.CrossRefGoogle ScholarPubMed
Broska, P., Martinho, E., Goodman, M. M. (1994) Comparison of the argon turnable laser with the flashlamp pulsed dye laser in the treatment of facial telangiectasia. Journal of Dermatologic Surgery and Oncology 20:749753.CrossRefGoogle Scholar
Hanes, F. M. (1909) Multiple hereditary telangiectasias causing hemorrhage (hereditary hemorrhagic telangiectasia). Bulletin of the Johns Hopkins Hospital 20: 6373.Google Scholar
Haye, R., Austad, J. (1992) Hereditary hemorrhagic telangiectasia: Unsuccessful treatment with the flashamp-pulsed dye laser. Rhinology 30: 135137.Google ScholarPubMed
Harrison, D. F. N. (1957) Familial haemorrhagic telangiectases: a survey of a series treated by oestrogen therapy. Journal of Laryngology and Otology 71: 577596.CrossRefGoogle ScholarPubMed
Harrison, D. F. N. (1982) Use of estrogen in treatment of familial hemorrhagic telangiectasia. Laryngoscope 92: 314319.Google Scholar
Illum, P., Bjerring, P. (1988) Hereditary hemorrhagic telangiectasia treated by laser surgery. Rhinology 26: 1924.Google ScholarPubMed
McCaffrey, T. V., Kern, E. B., Lake, C. F. (1977) Management of epistaxis in hereditary hemorrhagic telangiectasia. Archives of Otolaryngology 103: 627630.Google Scholar
Perry, W. H. (1987) Clinical spectrum of hereditary hemorrhagic telangiectasia (Osier-Weber-Rendu disease). American Journal of Medicine 82: 989997.CrossRefGoogle Scholar
Saunders, W. H. (1960) Permanent control of nosebleeds in patients with hereditary hemorrhagic telangiectasia. Annals of Internal Medicine 53: 147152.Google ScholarPubMed
Shapsay, S. M., Oliver, P. (1984) Treatment of hereditary hemorrhagic telangiectasia by Nd-YAG laser photocoagulation. Laryngoscope 94: 15541556.CrossRefGoogle Scholar
Siegel, M. B., Keane, W. M., Atkins, J. P., Rosen, M. R. (1991) Control of epistaxis in patients with hereditary hemorrhagic telangiectasia. Otolaryngology – Head and Neck Surgery 105: 675679.CrossRefGoogle ScholarPubMed
Tan, O. T., Sherwood, K., Gilchrest, B. A. (1989a) Treatment of children with port-wine stains using the flashlamp-pulsed tunable dye laser. New England Journal of Medicine 320: 416421.CrossRefGoogle ScholarPubMed
Tan, O. T., Murray, S., Kurban, A. K. (1989b) Action spectrum of vascular specific injury using pulsed irradiation. Journal of Investigative Dermatology 92: 868871.Google Scholar