Fluorescein-guided intraoperative endoscopy in patients with hereditary hemorrhagic telangiectasia: first impressions

Fabio Pagella, Alessandro Pusateri, Dario Zaccari, Daniele Bongetta, Cesare Zoia, Giuseppe Spinozzi, Carla Olivieri, Elina Matti

Research output: Contribution to journalArticle

Abstract

Background: Hereditary hemorrhagic telangiectasia (HHT) is a rare genetic disease that results in mucocutaneous telangiectasias and arteriovenous visceral malformations. Nasal telangiectasias lead to recurrent epistaxis, which affects up to 96% of patients. Different morphologic classifications and methods of visualization of nasal lesions have been described in the literature. We developed a new method of intraoperative endoscopy based on the intravenous administration of fluorescein. Preliminary data of this technique are reported. Methods: After the intravenous administration of sodium fluorescein, an intraoperative fluorescein-guided endoscopy was carried out using photographic customized yellow filters on top of a 0-degree, 4-mm endoscope. Results: In 2015, 65 HHT patients underwent surgery for their epistaxis in our institution, and in 7 patients (3 males, 4 females; mean age, 54 years) an intraoperative fluorescein-guided intraoperative nasal endoscopy was performed. No adverse events or complications were observed. Conclusion: First impressions regarding the usage of this technique in HHT patients seem to be promising and positive in terms of efficacy and safety. However, further studies with larger cohorts of patients should be performed in order to better investigate the use of this method for diagnostic and surgical purposes in HHT.

Original languageEnglish
Pages (from-to)300-303
Number of pages4
JournalInternational Forum of Allergy and Rhinology
Volume7
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

Keywords

  • endoscopy
  • epistaxis
  • hemorrhagic disorders
  • hereditary
  • hereditary hemorrhagic telangiectasia
  • HHT
  • Rendu-Osler-Weber disease

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

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