Abstract
Objectives: Hereditary hemorrhagic teleangiectasia (Osler's disease) is an autosomal dominant disease of the vascular connective tissue. One of the main symptoms is recurrent epistaxis. Diverse treatment options have been discussed in the literature, preference being given to various laser systems (eg, Nd:YAG, argon, and KTP lasers). Their exact dosing and excellent viewing ensure specific tissue-preserving treatment of affected areas. This study presents the first results of 940-nm diode laser treatment of recurrent epistaxis in Osler's disease. This treatment has not been previously described in the literature. The biophysical properties of the 940-nm diode laser with an average optical penetration depth of 2 to 4 mm offer a promising therapeutic approach for the treatment of teleangiectatic vascular areas.
Methods: Between 1998 and 2002, we treated 23 patients with the 940-nm diode laser from the Dornier Company. Therapy was primarily performed on an outpatient basis under topical anesthesia in the fiber-guided, noncontact mode using a special diascope with the compression-coagulation method under endoscopic control. The follow-up was between 12 and 24 months.
Results: The treatment considerably reduced the frequency and severity of epistaxis and improved the quality of life in all patients. However, the duration of the therapeutic effect showed strong individual variation. Treatment had to be repeated at different time intervals.
Conclusions: The 940-nm diode laser is a useful instrument to previous treatment modalities in recurrent epistaxis in Osler's disease.