Escleroterapia local con Polidocanol (Etoxisclerol®) para el tratamiento de las epístaxis en la enfermedad de Rendu-Osler-Weber o Telangiectasia Hemorrágica Hereditaria (HHT)

[EN] Hereditary Haemorrhagic Telangiectasia or Rendu-Osler-Weber disease is a rare multisystemic vascular disease with an autosomal dominant inheritance pattern. The mutations lead to vascular malformations in different locations, such as telangiectases in the nasal and gastric mucosa and arterioven...

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Detalles Bibliográficos
Autor: Morais Pérez, Darío
Tipo de recurso: artículo
Fecha de publicación:2014
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/125013
Acceso en línea:http://hdl.handle.net/10366/125013
Access Level:acceso abierto
Palabra clave:Otorrinolaringología
Telangiectasia Hemorragica Hereditaria
Enfermedad de Rendu-Osler-Weber
Epístaxis
Polidocanol
Inyección submucosa
Hereditary Haemorrhagic Telangiectasia
Rendu-Osler-Weber
Epistaxis
Polydocanol
Submucosal injection
32 Ciencias médicas
Descripción
Sumario:[EN] Hereditary Haemorrhagic Telangiectasia or Rendu-Osler-Weber disease is a rare multisystemic vascular disease with an autosomal dominant inheritance pattern. The mutations lead to vascular malformations in different locations, such as telangiectases in the nasal and gastric mucosa and arteriovenous malformations in liver, lungs and brain. Epistaxis or nose bleeding results from ruptures of telangiectases present in the nasal mucosa, and it is the most frequent clinical manifestation appearing in 93% of HHT patients and leading many patients to have a poor quality of life. Several treatments have been used to reduce epistaxis, but none have been completely effective: from nose packing, to selective and supraselective embolizations, including pharmacological therapy, chemical cauterizations, laser or more aggressive surgical techniques, such as septodermoplasty or Young’s occlusion. Sclerotherapy in the treatment of epistaxis in HHT, using different compounds Ethybloc®, Fibrin glue (Tissucol®), Polydocanol (Aethoxysclerol®) have also been used. We were the first to use the Polydocanol or Lauromacrogol 400 (Aethoxysklerol®) in nasal submucosal infiltrations in all the world and our first results were published in 2000. So far, we have treated 105 patients since 1996, all under local anesthesia, and the results have been highly satisfactory with up to 95% improvement in effectively controlling epistaxis, as well as a high level of patient satisfaction, and with 2.0 % showing minimal side effects.