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Managing epistaxis in hereditary haemorrhagic telangiectasia: a comprehensive narrative review of therapeutic horizons

Published online by Cambridge University Press:  11 November 2024

Youssef El Sayed Ahmad Open the ORCID record for Youssef El Sayed Ahmad [Opens in a new window] ,
Smile Kajal  and
Akaber Halawi
Youssef El Sayed Ahmad*
Affiliation:
MedStar Health, Baltimore, MD, USA Maryland ENT, Baltimore, MD, USA LifeBridge Health, Baltimore, MD, USA
Smile Kajal
Affiliation:
MedStar Health, Baltimore, MD, USA Maryland ENT, Baltimore, MD, USA LifeBridge Health, Baltimore, MD, USA
Akaber Halawi
Affiliation:
MedStar Health, Baltimore, MD, USA Maryland ENT, Baltimore, MD, USA LifeBridge Health, Baltimore, MD, USA
*
Corresponding author: Youssef El Sayed Ahmad; Email: youssefelsayedahmad@gmail.com
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Abstract

Background

Hereditary haemorrhagic telangiectasia is an autosomal dominant vascular disorder characterised by mucocutaneous telangiectasia, leading to recurrent epistaxis in nearly all affected individuals. Treatment strategies are broadly categorised into conservative, medical and surgical approaches. This study aimed to provide a concise summary of the existing literature on epistaxis associated with hereditary haemorrhagic telangiectasia.

Methods

The Medline/PubMed database was searched for relevant articles using the keywords ‘hereditary haemorrhagic telangiectasia’, ‘Osler-Weber-Rendu’ and ‘epistaxis’.

Results

Out of 93 reviewed articles, 59 contained pertinent information. Interventions were categorised into self-delivered therapy, intravenous treatment, in-office procedures and surgical intervention.

Conclusion

A stepwise approach to managing epistaxis in patients with HHT involves a gradual escalation of treatments, starting with conservative measures and progressing to more invasive interventions as necessary. Topical oils can be efficient and intranasal bevacizumab injection shows promise, but more data are needed. Surgical options range from bipolar cautery and laser therapy to complete closure of the nasal cavity. Proper patient selection remains crucial.

Keywords

hereditary hemorrhagic telangiectasiaOsler-Weber-Renduepistaxishemostasis

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 5 , May 2025 , pp. 389 - 394
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Youssef El Sayed Ahmad takes responsibility for the integrity of the content of the paper

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