Journal of Clinical Case Reports

Novel Use of Nasal Septal Button for Epistaxis in HHT Syndrome: An Observational Study

Abstract

Nacouzi M, Rohayem Z and Romanos B

Osler-Rendu-Weber or HHT (Hereditary Hemorrhagic Telangiectasia) is a genetic disease that causes patients to bleed, especially from the nose (epistaxis). The management of epistaxis in HHT is often very complex and frustrating. Epistaxis affects patient’s quality of life but can also be life threatening highlighting the importance of finding a permanent solution for this problem. Multiple management strategies have been proposed: packing, chemical and electrical cauterization, septodermoplasty, embolization, SPA ligation, antifibrinolytic agents. In the present study, we discuss the case of three patients with HHT and recalcitrant epistaxis who failed most of these strategies. The placement of nasal silicone septal button was shown to incidentally decrease significantly the incidence of bleeding in one patient by isolating the septal mucosa. The same procedure was then offered to the two other patients with similar success in decreasing bleeding and transfusion rate over 4 years of follow up.