Using the KTP laser to control epistaxis in patients with hereditary hemorrhagic telangiectasia

Abstract

Hereditary hemorrhagic telangiectasia (HHT), labeled Osler-Weber-Rendu Disease, is a systemic autosomal dominant disorder involving blood vessels, and is characterized by a triad of features including telangiectasia, recurrent epistaxis, and positive family history. Over the last 100 years since the disease was first described, no therapy has completely resolved the epistaxis. However, for reducing the frequency of the epistaxis and bleeding time, several treatments for the epistaxis have been reported. Since the early 1980s, laser therapy has been considered a useful method for patients with HHT because the laser can be used to specifically target tissues and vasculature, depending on the absorbance and transmittance of the tissues. Although various lasers have been evaluated, the potassium-titanyl-phosphate (KTP) laser is relatively rare. We present the case of a 64-year-old woman with HHT who underwent the KTP laser procedure in an out-patient setting. She had telangiectasia of the tongue, lip, skin, and intranasal membrane. She also had recurrent epistaxis and positive family history, which resulted in a diagnosis of HHT. The technique uses a low-power setting of approximately 0.5 to 2.0 watts with continuous wave. She underwent the procedure 8 times. The technique using the KTP laser for photocoagulation of intranasal telangiectases, and some considerations about epistaxis with HHT are presented. This technique resulted in reduction of the frequency of epistaxis, a decrease in the bleeding time, and improvement of the quality of life for this patient. We suggest that KTP laser therapy is a successful method for controlling epistaxis in patients with HHT.