Radiofrequency ablation for treatment of hereditary hemorrhagic telangiectasia lesions: "how i do it": With Illustration and Video

Introduction: Hereditary hemorrhagic telangiectasia (HHT) can cause significant epistaxis for those that suffer from it. Traditaional surgical treatments are ablative and can cause thermal damage. Radiofrequency (RF) energy can potentially be used to ablate HHT plaques at a lower temperature. In this article we describe our use of RF energy to treat HHT. Methods: A Coblation Evac70 wand was used with patients under general anesthetic to ablate visible lesions. The surgical technique is described in detail. Results: Thirty-seven patients have been treated over a 3-year time span showing significant improvement in epistaxis severity as measured by the Epistaxis Severity Score. There were three septal perforations that developed, but these were all in patients who had undergone several prior septal cauteries. Conclusion: RF energy via Coblation is an effective and safe means of surgically treating HHT lesions, with good epistaxis severity improvement and minimal patient morbidity.