ND-YAG LASER THERAPY OF RECURRENT EPISTAX IS IN HEREDITARY HEMORRHAGIC TELEANGIECTASIA

Background: Epistaxis is the leading symptome of hereditary hemorrhagi c teleangiectasia (HHT). Over the last years several laser systems hav e been used for therapy. Only a few studies have published results of Nd:YAG laser therapy evaluating a larger number of patients. Patients and methods: From 1987 through 1996, forty-one patients with HHT were treated with a Nd:YAG laser due to recurrent epistaxis at the Departme nt of Otorhinolaryngology of Kiel University. Thirty-two patients were followed-up over a period of a least 24 months. A centripetal techniq ue was used for endonasal laser light application (15-25 Watts; 0.1-0. 5 s), i.e., the laser light was applied from the periphery towards the center of the angiodysplasia. Intensive preoperative and postoperativ e nasal care with ointments was performed. Results: Bleeding frequency and intensity decreased in 30 (94%) patients. Duration of the therape utical success differed individually and varied from seven weeks to 14 months. Repeated laser therapy was necessary in 27 of 32 patients. Co nclusion: The Nd:YAG laser is a suitable tool in the treatment of epis taxis in HHT. This procedure is less traumatic, less painful, and can be repeated multiple times. Nd:YAG laser therapy and other therapeutic options cannot obtain a lasting cure of Rendu-Osler-Weber syndrome. H owever, in the vast majority of cases recur rent nasal bleeding as the dominant symptom can be reduced in frequency as well as in intensity.