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Long ‐term experience with intranasal bevacizumab therapy
ConclusionsIntranasal bevacizumab injection is an effective treatment for most of the moderate and severe grades of HHT‐associated epistaxis. The duration of the effect of the treatment was variable. Primary and late resistance phenomena to the treatment were quite common. Level of Evidence4. Laryngoscope, 2018
Source: The Laryngoscope - February 22, 2018 Category: ENT & OMF Authors: Johan Steineger, Terje Osnes, Ketil Heimdal, Sinan Dheyauldeen Tags: Allergy/Rhinology Source Type: research

Pazopanib effective for bevacizumab ‐unresponsive epistaxis in hereditary hemorrhagic telangiectasia
We describe a patient with HHT with epistaxis recalcitrant to several endonasal procedures and six cycles of intravenous bevacizumab, for which he was dependent on iron infusions and packed red blood cells transfusions. He then started pazopanib at 100 mg with dramatic improvements in epistaxis and normalization of hemoglobin and iron levels, without replenishment needs for 12 months. This is the first report on the efficacy of pazopanib with high selectivity for abrogating VEGF receptor‐2 signaling in HHT, and needs to be explored further. Laryngoscope, 2018
Source: The Laryngoscope - February 16, 2018 Category: ENT & OMF Authors: Joseph G. Parambil, Troy D. Woodard, Omer N. Koc Tags: Allergy/Rhinology Source Type: research

Osteonecrosis after intranasal injection with bevacizumab in treating hereditary hemorrhagic telangiectasia: A case report
Intranasal bevacizumab injections have been used in treating hereditary hemorrhagic telangiectasia (HHT)‐related epistaxis since 2009. It is believed to be a safe and effective treatment for a selected group of HHT patients in reducing frequency and intensity of epistaxis, with few or none adverse effects. In this case report, however, we will describe a patient who developed bilateral osteonecrosis in the knees while undergoing regular intranasal submucosal bevacizumab injections. Although osteonecrosis previously has been documented in patients receiving bevacizumab intravenously in oncologic doses, thus far it has not...
Source: The Laryngoscope - July 3, 2017 Category: ENT & OMF Authors: Johan Steineger, Else Merckoll, John Magnar Sl åstad, Erik Fink Eriksen, Ketil Heimdal, Sinan Dheyauldeen Tags: Allergy/Rhinology Source Type: research

Arterial ligation versus embolization in epistaxis management: Counterintuitive national trends
ConclusionCompared to embolization, ligation is associated with significantly decreased hospital charges and shorter hospital stay, without an increase in complication rates. Counterintuitively, ligation appears to be trending downward nationally in its use relative to embolization. Level of Evidence2C. Laryngoscope, 2016
Source: The Laryngoscope - December 22, 2016 Category: ENT & OMF Authors: Michael J. Sylvester, Sei Y. Chung, Luis A. Guinand, Aparna Govindan, Soly Baredes, Jean Anderson Eloy Tags: Allergy/Rhinology Source Type: research

The minimal important difference of the epistaxis severity score in hereditary hemorrhagic telangiectasia
ConclusionUsing both the anchor‐based and distribution‐based approaches, the estimated MID for the ESS in HHT is 0.71. Further implications include key metrics to help guide treatment responses in clinical care and essential information to calculate power and sample size for future clinical trials. Level of Evidence4. Laryngoscope, 2015
Source: The Laryngoscope - September 22, 2015 Category: ENT & OMF Authors: Linda X. Yin, Douglas D. Reh, Jeffrey B. Hoag, Sally E. Mitchell, Stephen C. Mathai, Gina M. Robinson, Christian A. Merlo Tags: Allergy/Rhinology Source Type: research

An evaluation of the severity and progression of epistaxis in hereditary hemorrhagic telangiectasia 1 versus hereditary hemorrhagic telangiectasia 2
ConclusionsHHT2 is associated with more severe epistaxis and a subsequent higher rate of interventions, requiring more aggressive therapy as compared to HHT1. Level of Evidence4 Laryngoscope, 2015
Source: The Laryngoscope - September 15, 2015 Category: ENT & OMF Authors: Benjamin N. Hunter, Benjamin H. Timmins, Jamie McDonald, Kevin J. Whitehead, P. Daniel Ward, Kevin F. Wilson Tags: Allergy/Rhinology Source Type: research

Domiciliary floseal prevents admission for epistaxis in hereditary hemorrhagic telangiectasia
Laryngoscope, 2014
Source: The Laryngoscope - May 2, 2014 Category: ENT & OMF Authors: Laura Warner, Jane Halliday, Karen James, John de Carpentier Tags: Allergy/Rhinology Source Type: research

Efficacy of a Topical Sesame/Rose Geranium Oil Compound in Patients with Hereditary Hemorrhagic Telangiectasia Associated Epistaxis
ConclusionA sesame/rose geranium oil compound can significantly reduce the epistaxis severity scores of patients with hereditary hemorrhagic telangiectasia‐related epistaxis. Level of Evidence4.
Source: The Laryngoscope - February 9, 2013 Category: ENT & OMF Authors: Douglas D. Reh, Kevin Hur, Christian A. Merlo Tags: Allergy/Rhinology Source Type: research