Der Langzeiteffekt der TruBlue Laser Behandlung auf Epistaxis bei Morbus Osler PatientInnen

Background: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular disease, characterized by recurrent and severe epistaxis. This study aims to evaluate the long-term effectiveness and safety of blue light laser therapy in managing epistaxis in HHT patients. Methods: A retrospective analysis was conducted on 71 patients treated between 09/2017 and 02/2023 at the Department of Otorhinolaryngology, University Hospital Regensburg. Patients underwent endonasal treatment using a pulsed diode laser with a 445 nm wavelength (Wolf TruBlue™ laser system), receiving between 2 and 13 treatment sessions. Results: A total of 351 laser treatments were administered, with no reported occurrences of nasal septal perforation. The Epistaxis Severity Score (ESS), a standardized measure of nasal symptoms in patients with HHT ranging from 0 to 10, decreased from a baseline of 3.92 (95% CI:3.69–4.14) to a final assessment of 3.26 (95% CI: 2.89–3.62), yielding a mean difference of 0.66 (p = 0.001). Subgroup analyses revealed that both the "moderate/severe" group (45.7%) and patients receiving 2–5 treatments (45.7%) achieved the minimal important difference (MID) of 0.71. In the "moderate/severe" group, the ESS decreased significantly from 4.99 (95% CI: 4.65–5.32) to 3.46 (95% CI: 2.91–4.00), resulting in a mean difference of 1.53 (p < 0.001). Patients receiving 2–5 treatments exhibited a significant mean reduction in ESS of 0.73, from 3.98 to 3.24 (p = 0.012). Furthermore, the Numeric Rating Scale (NRS) scores increased significantly from 5.08 to 6.67 (p < 0.001), indicating improved patient satisfaction. Conclusion: Our data not only reflect the safety of the TruBlue laser but also demonstrate its efficacy in reducing the intensity of nosebleeds in HHT patients.

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