耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
臨床
シリコーンカニューレの鼻腔内挿入により鼻出血を制御しえたオスラー病例
髙野 若菜草場 雄基植田 寛之増田 聖子
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2022 年 115 巻 5 号 p. 401-405

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We report the case of a male patient with Osler-Weber-Rendu disease who died of chronic heart failure that was exacerbated by anemia secondary to epistaxis. He had suffered from repeated episodes of epistaxis from approximately 20 years of age. Subsequently, he developed atrial fibrillation and mitral valve insufficiency and underwent mitral valve replacement at the age of 60 years. Postoperatively, he was prescribed anticoagulants, which increased the frequency of epistaxis and the amount of bleeding. At 64 years of age, he was hospitalized with heart failure and received a blood transfusion for the first time. He subsequently underwent vascular embolization of both maxillary arteries, but the epistaxis persisted. His epistaxis increased further in severity and the heart failure began to worsen from approximately 68 years of age. He suffered from massive epistaxis daily, but surgical treatment, such as nostril closure surgery, was not possible because of the severe heart failure. After nasal insertion of a silicon cannula, however, the volume of epistaxis decreased remarkably. Thus, in our patient, nasal insertion of a silicon cannula was useful for controlling epistaxis.

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