A NEW TECHNIQUE USING CULTURED EPITHELIAL SHEETS FOR THE MANAGEMENT OF EPISTAXIS ASSOCIATED WITH HEREDITARY HEMORRHAGIC TELANGIECTASIA

A new technique for the treatment of severe epistaxis associated with hereditary haemorrhagic telangiectasia is described. The nasal septum and inferior turbinates, surgically denuded of respiratory epithelium, were grafted using autografts of cultured epithelial sheets derived f rom buccal epithelium. All patients upon whom this technique has been used have shown considerable lessening in the frequency and severity o f their epistaxes although two patients received grafts on two occasio ns, in each case approximately three months apart. It is postulated th at a nasal lining of stratified squamous epithelium is likely to be mo re resistant to trauma than the normal respiratory type, and this is s upported by the observation that bleeds very seldom occur from the ora l cavity in this syndrome.