Treatment of choice in recurrent epistaxis in a patient with hereditary hemorrhagic telengiectasis:
Hereditary haemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu disease Autosomal dominant Affects blood vessels in skin, mucous membranes and viscera. Chromosome9q (HHT1) and chromosome 12q (HHT2) Curacao Criteriaa. Telangiectasia, b. A-V malformationsand aneurysmsc. Recurrent epistaxis occurs in 93% ofcases.d. Positive family history in first degree relatives. Rx-:a. Packingb. Cauteryc. Antifibrinolyticsd. Systemic or topical oestrogense. Coagulative lasersf. Septal dermoplasty( Treatment of Choice)g. Ligation and embolization h. Last reso permanent surgical closure of the nostrils(Young's operation)i. Laser photocoagulation with NdYAG, Argon and KTP532 Lasers
Anterior ethmoidal aery ligation
Septal dermoplasty
External carotid aery ligation
Internal carotid aery ligation
Epistaxis