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BRIEF RESEARCH REPORT article

Front. Allergy
Sec. Rhinology
Volume 5 - 2024 | doi: 10.3389/falgy.2024.1456686
This article is part of the Research Topic Recent Advances in Rhinology 2024 View all articles

Innovations in the management of epistaxis secondary to hereditary hemorrhagic telangiectasia: Our evolution to Injection Sclerotherapy as the treatment of choice

Provisionally accepted
Nitish Kumar Nitish Kumar Pedro L. Gomes Pedro L. Gomes Michael J. Marino Michael J. Marino Amar Miglani Amar Miglani Devyani Lal Devyani Lal *
  • Mayo Clinic Arizona, Scottsdale, United States

The final, formatted version of the article will be published soon.

    We compared the efficacy of intralesional sclerotherapy using 3% sodium tetradecyl sulfate with non-sclerotherapy-based treatments for Hereditary Hemorrhagic Telangiectasia-associated epistaxis management.Methodology: This is a retrospective study of patients who underwent surgical intervention for HHT-associated epistaxis management from 01/2010-02/2024. Patients undergoing sclerotherapy with intralesional 3% sodium tetradecyl sulfate were included in the sclerotherapy group and others undergoing conventional non-sclerotherapy-based procedures in the non-sclerotherapy group. Outcomes like breakthrough epistaxis, emergency visits, intra-op blood loss, blood transfusions, and procedure complications in the 3-month perioperative period were compared.Results: Twenty-three patients who underwent 74 intranasal procedures were identified. In the sclerotherapy group, 17 patients underwent 47 procedures. In the non-sclerotherapy group, 10 patients underwent 27 procedures. Till the 3 rd post-treatment month, breakthrough epistaxis was significantly less after sclerotherapy procedures (13/47) vs. non-sclerotherapy procedures (14/27); (p=0.037). Intraoperative blood loss was significantly lower during sclerotherapy (median:10mL) vs. non-sclerotherapy procedures (median:50mL); p<0.001. The time interval between successive procedures was not significantly different in the sclerotherapy (median 6.5 months) vs. the non-sclerotherapy group (median 3.5 months); p=0.13. Nasal crusting was the most common complication in the sclerotherapy group (36.9%). Two patients in each group had new onset septal perforation, none of the patients had vision loss or cerebrovascular accident.One emergency department visit was reported in the sclerotherapy group vs. 7 (in 3 patients) in the non-sclerotherapy group.Conclusions: Compared to non-sclerotherapy treatments, intralesional sclerotherapy for epistaxis in HHT is more effective in decreasing breakthrough epistaxis, and has lower intraoperative blood loss.

    Keywords: 3% sodium tetradecyl sulfate, Sclerotherapy, Epistaxis, Hereditary hemorrhagic telangiectasia, Genetic disorder

    Received: 29 Jun 2024; Accepted: 12 Aug 2024.

    Copyright: © 2024 Kumar, Gomes, Marino, Miglani and Lal. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Devyani Lal, Mayo Clinic Arizona, Scottsdale, United States

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