Diagnostic and therapeutic problems in Osler disease
Hauswald, B.; Tymnik, G.; Fritsche, F.
Zeitschrift für Arztliche Fortbildung 80(24): 1037-1038
1986
ISSN/ISBN: 0044-2178 PMID: 3577236 Document Number: 281310
Osler's disease is characterized by the following symptoms: recurring, progressive bleeding, dark red angiomas of needle to rice-grain size in the region of the anterior nasal mucosa, lips, mucosa of the oral cavity, mesopharynx and hypopharynx, skin of the face, and trunk, occasionally conjunctiva. Osler's disease is an inherited disease resulting from a gene mutation. Conventional treatments include the following: as emergency measures, anterior tamponade in layers; Bellocq tamponades; Seiffert inflatable balloons; occasionally, total anterior septum resection by the Kindler method or the Wirth modification; vascular ligatures; local injection with various drugs; chemical cauterization; galvanocauterization; cryotherapy; laser or infrared coagulation. In addition the following are recommended: intra-arterial embolization of the A. maxilleris interna by carotis external angiography and intranasal contact irradiation with cobalt, radium, or iridium. Plastic surgery of the septum by the Saunders method seems to be therapeutically effective; this involves removing the diseased mucosa of the anterior septum, the nasal fundus and the head of the turbinate bone and replacing them with skin of the fissure. In recent years outstanding therapeutic effects have been achieved by administration of hormonal contraceptives, especially by parenteral application of estrogen. In males this therapy is not without risks. It can be recommended for women with consideration of contraindications.