1/6. A novel treatment for patients with hereditary haemorrhagic telangiectasia.Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by dermal, mucosal, and visceral telangiectases as well as pulmonary and cerebral arteriovenous malformations. Recurrent epistaxis occurs in the majority of patients, and by the very nature of the thin walled vessels involved it is often refractory to conventional forms of treatment. We present the case of an 82-year-old lady with intractable epistaxis secondary to HHT, that was successfully controlled by the application of fibrin glue.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/6. Major vascular complications of orthognathic surgery: hemorrhage associated with Le Fort I osteotomies.Major intraoperative or postoperative bleeding associated with Le Fort I osteotomies can be venous and/or arterial in nature. Arterial hemorrhage generally involves the maxillary artery and its terminal branches. Arterial hemorrhage tends to be more persistent and can be recurrent, which makes it more difficult to manage. Postoperative bleeding following Le Fort I osteotomies generally presents as epistaxis and usually occurs initially within the first 2 weeks following surgery. Treatment modalities that have been used to successfully arrest postoperative hemorrhage include anterior and/or posterior nasal packing; packing of the maxillary antrum; reoperating with clipping or electrocoagulation of bleeding vessels, or the use of topical hemostatic agents in the pterygomaxillary region; external carotid artery ligation; and selective embolization of the maxillary artery and its terminal branches.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/6. A pregnant woman with severe epistaxis--a rare manifestation of folic acid deficiency.The case-history of a pregnant woman with a life-threatening thrombocytopenia, due to folic acid deficiency, caused by an extremely low dietary intake is described. As folic acid deficiency manifests itself in a variety of ways, its clinical features are not always easily recognized. Timely recognition is important because of the rapid progressive nature of the disorder, especially in pregnancy, and because rapid improvement is achieved by simple treatment: supplementation of the deficiency. This is well illustrated in the patient described in this case report. A short review of the literature is presented.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/6. Limited septoplasty as treatment for recurrent epistaxis in a child with Glanzmann's thrombasthenia.Recurrent epistaxis can be a serious problem in children with coagulation disorders. We present a case of severe, recurrent nosebleeds in a 3-year-10-month-old boy with Glanzmann's thrombasthenia. The nature of Glanzmann's disease and medical treatment of epistaxis in children is reviewed. A method of controlling recurrent epistaxis with a very simple and limited septoplasty is described. This technique should be applicable to patients with recurrent nosebleeds and other more common coagulation disorders.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/6. epistaxis originating from traumatic pseudoaneurysm of the internal carotid artery: diagnosis and endovascular therapy.Posttraumatic pseudoaneurysm of the internal carotid artery (ICA) is an uncommon but potentially fatal cause of epistaxis. Because the onset of delayed bleeding from the time of injury is variable, prompt diagnosis of cavernous ICA pseudoaneurysm is often a clinical challenge. The relative urgency to evaluate for this disease is highlighted by the morbid nature of this entity. Optimal management demands rapid recognition and treatment to give the best functional outcome. The authors present a case series of six patients with skull base ICA pseudoaneurysm. A unifying feature in the majority of patients is the development of delayed, massive epistaxis. The time course for presentation of delayed life-threatening epistaxis ranged from 5 days to 9 weeks. Two patients exhibited the classic triad of unilateral blindness, orbital fractures, and massive epistaxis. All patients requiring intervention were successfully treated with endovascular embolization techniques that included detachable balloons and coils. The clinical and radiologic findings in this case series are presented. The relevant anatomy, diagnosis, and treatment of traumatic ICA pseudoaneurysm are reviewed. A contemporary treatment strategy is proposed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/6. Claudication on mastication following bilateral external carotid artery ligation for posterior epistaxis.This case highlights a potentially disabling complication of intermittent claudication in the region of the masseter muscles on mastication, following bilateral external carotid artery ligation for epistaxis. Although there have been few reports of this complication this may be a reflection of the fact that the operation is rarely performed, and not because the complication is rare. Its potentially disabling nature, and its possible common occurrence after this procedure make awareness of it by surgeons who may carry out this procedure important.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |