Experience with Argon Plasma Coagulation in Treatment of Recurrent Epistaxis in Patients with Hereditary Hemorrhagic Telangiectasia
Abstrakt
Objective: Hereditary hemorrhagic telangiectasia, or Rendu-Osler-Weber disease, is an autosomal dominant genetic disorder characterized by abnormal vessel formation. Otorhinolaryngologists often struggle with recurrent epistaxis caused by telangiectasias of the nasal mucosa.
Many types of local treatments have been reported, including argon plasma coagulation, which is a non-contact electrocoagulation method used widely in surgery. The goal of this retrospective study was to enlist all patients with hereditary hemorrhagic telangiectasia treated with argon plasma coagulation for recurrent epistaxis at our department and to assess our experiences with the method.
Methods: This study includes all hereditary hemorrhagic telangiectasia patients treated by argon plasma coagulation at our department starting from 2010, the year when we began using the method, until 2019. Most patients also applied topical estriol ointment in conjunction with the treatment.
All patients complained of frequent heavy epistaxis before the surgery and some even required repeated blood transfusions. Results: Thirty-six patients underwent argon plasma coagulation in the monitored period (2010-2019) with mean age 54.75 and median age 59.5 years.
All patients had telangiectasias in the nasal cavity. The oral mucosa and skin were also frequently affected, and 2 patients had telangiectasias in other organs.
Twenty-two patients had more than 1 procedure, with a maximum of 16. All patients were satisfied with the effect of argon plasma coagulation on the severity and frequency of their epistaxis, and no major complications during or after the surgery were reported.
Conclusion: Argon plasma coagulation seems to be a safe, minimally invasive, and effective method in managing recurrent epistaxis in hereditary hemorrhagic telangiectasia patients.