Hereditary Hemorrhagic Telangiectasia: Effective Treatment of Epistaxis by Septal Dermoplasty

Abstract

The severe, sometimes daily, nosebleeds of patients with hereditary hemorrhagic telangiectasia can now be controlled effectively by a surgical procedure called septal dermoplasty. In this operation the principle is to replace the fragile epithelium in the anterior one-third of the nose by a split-thickness graft of skin from the thigh. The skin graft, being tough, resists trauma and prevents bleeding. Results in over 100 patients demonstrate that the procedure is effective. Some patients never bleed again while others, who do bleed occasionally, do so much less severely and less often. Other uses for the septal dermoplasty operation include closure of septal perforations, treatment of chronic septal ulceration, and reconstruction of the septum after removal of certain tumors.