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The Young's procedure for severe epistaxis from hereditary hemorrhagic telangiectasia.

Abstract

BACKGROUND
Surgical treatment of epistaxis in hereditary hemorrhagic telangiectasia (HHT) has historically been managed with the laser procedure or the septodermoplasty procedure. For transfusion-dependent patients with severe epistaxis we have been performing the Young's procedure or surgical closure of the nostrils. The objective of this study was to report treatment of severe epistaxis related to HHT with the Young's procedure and assess patient outcome.
METHODS
Patients with severe iron or blood transfusion-dependent epistaxis who underwent a Young's procedure in three otolaryngology HHT centers were reviewed. Patients were evaluated for postoperative epistaxis and subjective outcome.
RESULTS
Forty-three patients underwent a Young's procedure for severe epistaxis and were observed for a mean of 34 months. The procedure was well tolerated by all patients and 30 of 36 patients (83%) experienced complete cessation of bleeding after the Young's procedure. Patients had a mean increase in hemoglobin of 4.68 g/dL after the procedure. The average Glasgow Benefit Inventory score after surgery was 43.56. No patients requested a reversal of the procedure.
CONCLUSION
The Young's procedure is a safe and efficacious procedure with complete cessation of epistaxis in most patients with severe epistaxis and HHT.

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  • Publisher Full Text
  • Authors

    Richer SL, Geisthoff UW, Livada N, Ward PD, Johnson L, Mainka A, Henderson KJ, Maune S, White RI, Ross DA

    Institution

    Department of Surgery, St. Vincent's Medical Center, Bridgeport, Connecticut 06606, USA. sara.richer@stvincents.org

    Source

    American journal of rhinology & allergy 26:5 pg 401-4

    MeSH

    Adult
    Aged
    Epistaxis
    Feasibility Studies
    Female
    Follow-Up Studies
    Humans
    Male
    Middle Aged
    Nasal Surgical Procedures
    Natural Orifice Endoscopic Surgery
    Retrospective Studies
    Telangiectasia, Hereditary Hemorrhagic
    Treatment Outcome

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    23168156