No funding was receied for this work.
Article first published online: 11 NOV 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 121, Issue 3, pages 644–646, March 2011
How to Cite
Chen, S., Karnezis, T. and Davidson, T. M. (2011), Safety of intranasal Bevacizumab (avastin) treatment in patients with hereditary hemorrhagic telangiectasia-associated epistaxis. The Laryngoscope, 121: 644–646. doi: 10.1002/lary.21345
The authors have no financial disclosures for this article.
The authors have no conflicts of interest to disclose.
- Issue published online: 18 FEB 2011
- Article first published online: 11 NOV 2010
- Manuscript Accepted: 31 AUG 2010
- Manuscript Received: 6 AUG 2010
- hereditary hemorrhagic telangiectasia;
- Osler Weber Rendu;
- Level of Evidence: 2b
Assess for complications of intranasal Bevacizumab application in patients with hereditary hemorrhagic telangiectasia (HHT)-associated epistaxis.
Retrospective chart review.
In 58 patients presenting with recurrent HHT epistaxis, Bevacizumab was applied intranasally either as a submucosal injection or as a topical spray between October 2006 and June 2010. In many of the injected patients, the potassium titanyl phosphate (KTP) laser was used adjunctively for vessel photocoagulation. A phone interview was performed in July 2010 to assess for treatment complications.
Of the 58 treated patients 52 were contacted. Patient surveys were performed 1.5 to 46 months following their initial Bevacizumab treatment. Within the treatment population, five patients had sustained a septal perforation. Notably, these patients were treated early in the study period at which time the cartilaginous septum was often both injected and lasered. Subsequently, the treatment protocol was changed and the cartilaginous septum was neither lasered nor injected. After these changes were made no additional septal perforations were identified. No other adverse events were associated with intranasal Bevacizumab treatment.
Bevacizumab applied as either a submucosal injection or as a topical nasal spray, with or without application of the KTP laser, is a safe treatment regimen. Still, when Bevacizumab injections are performed, the cartilaginous nasal septum should be avoided as patients may develop septal perforations. Laryngoscope, 2011