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80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

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Closure of the nasal cavity modified after YOUNG as a treatment of epitaxis in hereditary hemorrhagic teleangiectasia

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German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hno103

doi: 10.3205/09hno103, urn:nbn:de:0183-09hno1034

Published: July 22, 2009

© 2009 Mainka et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Introduction: Recurrent epistaxis in cases of hereditary hemorrhagic teleangiectasia (HHT, Morbus Osler) can lead to severe morbidity and drastic reduction of quality of life (QOL). Anemias requiring transfusions and concomitant diseases may necessitate radical interventional measures.

Method: In 8 patients the nostrils were closed in a modified way that Young described (7 cases bilateral, 1 case unilateral). A standardized interview including the Glasgow Benefit Inventory targeting the result of the intervention an the postoperative QOL was performed.

Findings: In all 8 cases the nose bleeding ceased completely (provided that the closure stayed complete), the time of follow-up ranging from 6 to 40 months. In 2 cases the nostrils were reopened: one because of a malignant tumor, the other one because oral breathing was not tolerated. Other relevant side effects were not observed. The majority of the patients experienced a considerable improvement of QOL and stated that regiven the choice they would go for the operation again.

Conclusion: The closure of the nasal cavity represents a valuable treatment option in HHT in selected cases. It is the only therapy so far, which leads to a complete and enduring cessation of the epistaxis. QOL increased despite of side effects like the obligate mouth breathing.