gms | German Medical Science

Blood vessels on the surface of the nasal mucosa are often the cause for recurrent epistaxis. Radiofrequency coagulation (RF coagulation) appears to be a new method for the treatment of such vessels with the advantage of causing less thermal damage to the surrounding mucosa than conventional bipolar cautery.

Material and methods: RF-coutry was applied to a total of 15 patients (13 to 76 years of age; 11 adults with HHT and 4 teenagers with habitual epistaxis ). The unit used was the RF generator BM-780 II with the ORL set Marinescu (Sutter Medizintechnik, Freiburg/Germany) and a straight ball electrode (long shaft, electrode diameter 3 mm) in the monopolar mode. With the help of an 30° angled endoscope pathologically affected vessels could be sealed systematically.Setting: monopolar coagulation, contact mode at level 2. The duration of each application was only a few seconds. After therapy the nose was packed with CMC (Sinu-Knit^®) and rinsed with destilled water.

Results: No patients suffered from intraoperative complications. During the average post-operative follow-up time of six months (time frame: 2 to 12 months) no major complications occurred (such as septum perforation, major intraoperative or postoperative bleedings, large surface thermal mucosa damage). The frequency and intensity of recurrent bleeding could be reduced by 70%.

Discussion: RF coagulation may be a cost-effective alternative for the treatment of telangiectasia of the nasal mucosa, without leading to significant tissue disturbances. This method seems to be beneficial for patients with a disease pattern that does not respond to laser therapy. It is also possible to switch to the bipolar RF coagulation mode with the tissue temperature remaining far below that of conventional bipolar coagulation.