Pulse
Novel Approach
Researchers try sclerotherapy for nosebleeds.
By Carmen Peota
University of Minnesota assistant professor of otolaryngology Holly Boyer, M.D., is looking at using sclerotherapy, a treatment commonly used for varicose veins, to manage nosebleeds in people with a condition called hereditary hemorrhagic telangiectasia (HHT). The genetic vascular disorder, which affects about one in 5,000 people, causes blood vessels to lose their elasticity and become permanently dilated and malformed.
Although the condition affects vessels in the brain, liver, lung, and gastrointestinal tract as well the nose, it nearly always causes nosebleeds, as the fragile vessels in the nasal passages are easily damaged by dryness and nasal crusting. The lack of elasticity in the blood vessels prevents constriction, making bleeding difficult to control. As people with HHT age, the frequency and severity of their nosebleeds often increases.
| To find out more about the clinical trial, contact Patricia Fernandes at 612-626-3018 or ferna079@umn.edu. |
Boyer and her team got the idea for trying sclerotherapy, which involves inserting a needle into a blood vessel and injecting foamed sodium tetradecyl sulfate solution, for nosebleeds in patients with HHT after using it for large lesions in blood vessels in the larynx and pharynx. They initially tried the procedure using general anesthesia. When they found it caused only minimal bleeding, they felt confident about trying it with local anesthesia, making it feasible to do the procedure in an office setting.
In an article published in August in the International Forum of Allergy & Rhinology, Boyer and her co-authors reported on seven patients who underwent the procedure. All of them reported having significantly less frequent and less severe nosebleeds after sclerotherapy than before it and said that they would undergo the procedure again.
Boyer and her team have received funding from the American Rhinologic Society for a clinical trial of sclerotherapy for nosebleeds related to HHT. They began enrolling patients in September and so far have three participants (they’re hoping for 38). They hope their new therapy provides an option for people that is effective, more convenient, and less expensive than other treatments, including electrical or chemical cauterization or laser treatment, which require general anesthesia.