Hereditary haemorrhagic telangiectasia--microembolization in the management of epistaxis

Hereditary haemorrhagic telangiectasia: Young's procedure in the management of epistaxis

Two cases of hereditary haemorrhagic telangiectasia are presented. Epistaxis was intractable in both patients. Young's procedure proved successful in controlling nose bleeds. One of the patients has been followed-up for 14 years. Methods of treatment are discussed with a review of the literature.

Embolisation techniques in neuroradiology

Embolisation is a definitive treatment for selected arteriovenous fistulas, aneurysms and both extra- and intra-axial angiomatous malformations. It is an effective emergency treatment for many cases of intractable epistaxis. It is useful prior to surgery to reduce blood loss from hypervascular tumours, including juvenile angiofibromas, paragangliomas and basal meningiomas, and from angiomas or soft tissue or of bone prior to excision, dental extraction or laminectomy. Embolisation is a satisfactory palliative treatment for angiomas involving superficial tissues, in which the cosmetic effects of surgery are unlikely to be satisfactory, and of mucosal surfaces causing intractable bleeding. In inoperable tumours, embolisation can relieve pain, bleeding, pulsatile tinnitus or discomfort due to mass effect.