Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T23:14:21.480Z Has data issue: false hasContentIssue false
  • English
  • Français

A new technique using cultured epithelial sheets for the management of epistaxis associated with hereditary haemorrhagic telangiectasia

Published online by Cambridge University Press:  29 June 2007

Catherine M. Milton ,
J. C. Shotton ,
D. J. Premachandran ,
Barbara M. Woodward ,
J. W. Fabre  and
R. J. Sergeant
Catherine M. Milton*
Affiliation:
Department of Otolaryngology Kent and Sussex Hospital, Tunbridge Wells
J. C. Shotton
Affiliation:
Department of Otolaryngology Kent and Sussex Hospital, Tunbridge Wells
D. J. Premachandran
Affiliation:
The Blond Mclndoe Centre for Medical Research, Queen Victoria Hospital, East Grinstead
Barbara M. Woodward
Affiliation:
Department of Otolaryngology, James Paget Hospital, Great Yarmouth
J. W. Fabre
Affiliation:
Department of Otolaryngology, James Paget Hospital, Great Yarmouth
R. J. Sergeant
Affiliation:
Department of Otolaryngology Kent and Sussex Hospital, Tunbridge Wells
*
Miss Catherine M. Milton, Department of Otolaryngology, Kent and Sussex Hospital, Tunbridge Wells, Kent TN4 8AT
Get access Rights & Permissions [Opens in a new window]

Abstract

A new technique for the treatment of severe epistaxis associated with hereditary haemorrhagic telangiectasia is described. The nasal septum and inferior turbinates, surgically denuded of respiratory epithelium, were grafted using autografts of cultured epithelial sheets derived from buccal epithelium. All patients upon whom this technique has been used have shown considerable lessening in the frequency and severity of their epistaxes although two patients received grafts on two occasions, in each case approximately three months apart. It is postulated that a nasal lining of stratified squamous epithelium is likely to be more resistant to trauma than the normal respiratory type, and this is supported by the observation that bleeds very seldom occur from the oral cavity in this syndrome.

Keywords

EpistaxisTelangiectasiahereditary haemorrhagicEpithelial cellsautologousculturedTransplantationautologous
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 6 , June 1993 , pp. 510 - 513
Copyright
Copyright © JLO (1984) Limited 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Babington, B. G. (1865) Hereditary epistaxis. Lancet 2: 362–363Google Scholar
Dolowitz, D. A. (1953) Hereditary haemorrhagic telangiectasia. American Surgeon 19: 776–783Google Scholar
Fabre, J., Cullen, P. (1989) Rejection of cultured keratinocyte allografts in the rat: clinical implications and possible clue the enigma of skin graft rejection. Transplantation 48: 306–315CrossRefGoogle ScholarPubMed
Green, H., Kehinde, O., Thomas, J. (1979) Growth of cultured epidermal cells into multiple epithelia suitable for grafting. Proceedings of the National Academy of Science 76: 5665–5668CrossRefGoogle ScholarPubMed
Harrison, D. F. N. (1964) Familial haemorrhagic telangiectasia. Quarterly Journal of Medicine 129: 25–38Google Scholar
Jahnke, V. (1970) Ultrastructure of hereditary telangiectasia. Archives of Otolaryngology 91: 262–265CrossRefGoogle ScholarPubMed
Kindler, W., Tiedman, R. (1956) Zur Histopathologie und Therapie der scherwen Formen von Epistaxis bei der Rendu-Oslerschen Krankheit. Archives Ohren Nasen KehlkopJheilk 168: 441–460CrossRefGoogle Scholar
Letterman, G., Schurter, M. (1964) The split thickness skin graft in the management of hereditary haemorrhagic telangiectasia involving the nasal mucosa. Plastic and Reconstructive Surgery 34: 126–135CrossRefGoogle ScholarPubMed
McCabe, W. P., Kelly, A. P. (1972) Management of epistaxis in Osler–Weber–Rendu disease. Recurrence of telangiectases within a nasal skin graft. Plastic and Reconstructive Surgery 50(2): 114–118.CrossRefGoogle ScholarPubMed
Osler, W. (1901) On a family form of recurring epistaxes associated with multiple telangiectases of the skin and mucous membranes. Bulletin of the Johns Hopkins Hospital 12: 333–337Google Scholar
Premachandran, D. J., Woodward, B. M., Milton, C. M., Sergeant, R. J., Fabre, J. W. (1990) Treatment of postoperative otorrhoea by grafting of mastoid cavities with cultured autologous epidermal cells. Lancet 335: 365–367CrossRefGoogle Scholar
Rendu, M. (1896) Epistaxis repetes chez un sujet poteur de petits angiomes cutanes et muqueux. Bulletin Societe Medicine Hopital Paris 13: 731–733Google Scholar
Saunders, W. H. (1968) Septal dermoplasty-ten years experience. Transactions of the American Academy of Ophthalmology and Otolaryngology 72: 153–160Google ScholarPubMed
Sutton, H. G. (1864) Epistaxis as an indication of impaired nutrition and degeneration of the vascular system. Medical Mirror 1: 769–772Google Scholar
Weber, F. P. (1907) Multiple hereditary developmental angiomata (telangiectases) of skin and mucous membranes associated with recurring haemorrhages. Lancet 2: 160–162Google Scholar