• DOI:10.1017/S0022215100060382
• Corpus ID: 41411171

Septal Dermoplasty: A New Operative Procedure for Control of Nosebleeds in Patients with Hereditary Hæmorrhagic Telangiectasia

@article{Saunders1963SeptalDA,
  title={Septal Dermoplasty: A New Operative Procedure for Control of Nosebleeds in Patients with Hereditary H{\ae}morrhagic Telangiectasia},
  author={William H. Saunders},
  journal={The Journal of Laryngology \& Otology},
  year={1963},
  volume={77},
  pages={69 - 76}
}

• W. Saunders
• Published 1 January 1963
• Medicine
• The Journal of Laryngology & Otology

IN 1958, I reported a new operative procedure to correct the severe nosebleeds of patients with hereditary hasmorrhagic telangiectasia. The principle of the operation, called septal dermoplasty, is Jbo replace the fragile respiratory epithelium of the anterior part of the nose with a tougher epithelium: skin. At first the procedure was limited to a graft applied to the anterior half of each side of the nasal septum. Later the operation was extended to include grafting of the floor and the lateral walls of the nose, anteriorly. The posterior half of the nose, protected from most trauma, does not often bleed in this disorder. The severe, repeated, lifelong nosebleeds that mark hereditary haemorrhagic telangiectasia, or Rendu-Osler-Weber disease, are well known to most oto-laryngologists. Some patients with this disorder also bleed from the gastro-intestinal tract although such bleeding is less common than epistaxis. In fact, haemorrhage has been reported from virtually every body surface and into every organ. Nosebleeds which usually begin about puberty become worse as the patient grows older. One patient I have treated has required more than 2,000 blood transfusions. Several others have had more than 500 transfusions. A haemoglobin determination of four gms. is not infrequent.