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Laryngoscope. 2019 Oct;129(10):2210-2215. doi: 10.1002/lary.27889. Epub 2019 Feb 27.

Injection of bevacizumab and cyanoacrylate glue for hereditary hemorrhagic telangiectasia.

Author information

1
Department of Otolaryngology-Head and Neck Surgery/Skull Base Surgery, Hospital Groups Saint Louis, Lariboisière, Fernand-Widal, Public Assistance Paris Hospitals, Paris-Diderot University, Paris, France.
2
Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University, Faculty of Medicine, Beirut, Lebanon.

Abstract

OBJECTIVES/HYPOTHESIS:

The objective of this study was to report for the first time on the results of submucosal injections of bevacizumab used in conjunction with cyanoacrylate glue sclerotherapy in hereditary hemorrhagic telangiectasia (HHT).

STUDY DESIGN:

Retrospective analytic chart review.

METHODS:

We performed a chart review that included all patients with HHT treated with intranasal bevacizumab and cyanoacrylate glue for refractory epistaxis at Lariboisiere University Hospital from 2013 with a minimum follow-up of 6 months. We injected 100 mg (25 mg/mL) of bevacizumab diluted in 2 mL of serum at the base of the telangiectasias, and sclerotherapy with an injection of cyanoacrylate glue was used adjunctively. Treatment efficacy was based on changes in Epistaxis Severity Scores (ESS) and the Bergler-Sadick Scale. Quality of life and patient satisfaction were evaluated using the Cantril Self-Anchoring Ladder (CL) and Likert scale, respectively.

RESULTS:

Thirty-one patients were included, with a mean follow-up of 26.6 months. The average ESS score significantly decreased from 7.82 to 3.89 (P < .05). The Bergler-Sadick score significantly improved (P < .05) following the treatment, including the frequency (from 2.74 to 1.64) and the quantity (from 2.54 to 1.51) scales. Quality of life was significantly improved (P < .05) using the CL score (from 4.16 to 7.22). The Likert satisfaction scale related to the treatment efficacy was high, with an average of 7.03 out of 10. No complications were noted.

CONCLUSIONS:

Submucosal injections of bevacizumab in conjunction with cyanoacrylate glue sclerotherapy significantly reduced epistaxis and improved the quality of life in HHT. Prospective comparative studies are needed to further evaluate the significance of this treatment modality.

LEVEL OF EVIDENCE:

3b Laryngoscope, 129:2210-2215, 2019.

KEYWORDS:

Hereditary hemorrhagic telangiectasia; bevacizumab; epistaxis; quality of life; sclerotherapy

PMID:
31566760
DOI:
10.1002/lary.27889
[Indexed for MEDLINE]

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