Avastin and diode laser: A combined modality in managing epistaxis in hereditary hemorrhagic telangiectasia

Abstract A patient with hereditary hemorrhagic telangiectasia is a rare presentation to the otolaryngologist in clinical practice. They almost present with epistaxis, which is recurrent, spontaneous and can be functionally and socially debilitating for the patient. Diode laser cauterization and Avas...

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Bibliographic Details
Published in:American journal of otolaryngology 2013-09, Vol.34 (5), p.603-605
Main Authors: Marglani, Osama A., MD, FRCSC, Bawazeer, Naif A., MBBS, Abu Suliman, Omar A., MBBS
Format: Article
Language:English
Subjects:
Administration, Intranasal
Aged
Anemia
Angiogenesis Inhibitors - administration & dosage
Antibodies, Monoclonal, Humanized - administration & dosage
Bevacizumab
Epistaxis - etiology
Epistaxis - therapy
Family medical history
Follow-Up Studies
Hospitals
Humans
Kinases
Laser Therapy - methods
Lasers, Semiconductor - therapeutic use
Male
Mutation
Otolaryngology
Quality of life
Surgery
Telangiectasia, Hereditary Hemorrhagic - complications
Vascular Endothelial Growth Factor A - antagonists & inhibitors
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Summary:Abstract A patient with hereditary hemorrhagic telangiectasia is a rare presentation to the otolaryngologist in clinical practice. They almost present with epistaxis, which is recurrent, spontaneous and can be functionally and socially debilitating for the patient. Diode laser cauterization and Avastin intranasal injection showed significant improvement in epistaxis severity score. We report a case of hereditary hemorrhagic telangiectasia with chronic epistaxis (hemoglobin 3.4 mg/dl) managed with Diode laser and intranasal Avastin injection with great improvement in life quality and decrease in epistaxis attacks. Despite all treatment options absolute eradication of epistaxis attacks is difficult to obtain in these cases.
ISSN:0196-0709
1532-818X
DOI:10.1016/j.amjoto.2013.02.008