{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:05:00Z","timestamp":1787799900819,"version":"build-2784847793"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T00:00:00Z","timestamp":1553472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Epistaxis is the most frequent clinical manifestation of hereditary hemorrhagic telangiectasia (HHT). Several topical, systemic, and surgical treatments have been tried, but none have been completely effective. The aim of the present study is to evaluate whether a combined treatment sclerotherapy and topical therapy with propranolol 0.5% nasal formulation would reduce the epistaxis due to HHT and improve patient's quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An observational cross\u2010sectional study was carried out. The primary outcome measure was frequency and severity of epistaxis as measured by the epistaxis severity score (ESS) at baseline (4\u2009weeks before therapy) and at least 4\u2009weeks after the treatment was implemented. Quality of life was analyzed using EuroQol\u20105D (EQ\u20105D) scale and visual analogue (VAS) scale before and after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 38 consecutive patients subjected to the combined treatment were evaluated (mean age: 57.2\u2009years, standard deviation [SD]\u2009=\u200913.9; 60.5% women). The mean time of treatment was 37.1\u2009weeks (SD\u2009=\u200914.9). Combined therapy significantly reduces frequency and severity of epistaxis, with an ESS improvement of 5 points from 6.9\u2009\u00b1\u20092.6 to 1.9\u2009\u00b1\u20091.3 (<jats:italic>P<\/jats:italic> &lt;\u20090.05); however, the EQ\u20105D scale increased from 0.66\u2009\u00b1\u20090.27 to 0.93\u2009\u00b1\u20090.12 (<jats:italic>P<\/jats:italic> &lt;\u20090.05). The difference in VAS means showed an increase from 44.6\u2009\u00b1\u200928.3 to 82.5\u2009\u00b1\u200912.5 (<jats:italic>P<\/jats:italic> &lt;\u20090.05). The increases in quality of life are in line with the drop in ESS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study demonstrated that combined therapy (sclerotherapy and topical nasal propranolol) significantly reduced the epistaxis due to HHT and increased patients\u2019 quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 129:2216\u20132223, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27930","type":"journal-article","created":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T19:11:02Z","timestamp":1553541062000},"page":"2216-2223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Sclerotherapy and Topical Nasal Propranolol: An Effective and Safe Therapy for HHT\u2010Epistaxis"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0841-3881","authenticated-orcid":false,"given":"Santos","family":"Esteban\u2010Casado","sequence":"first","affiliation":[{"name":"Pharmacy Department University Hospital Alcorc\u00f3n Foundation  Alcorc\u00f3n Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Mart\u00edn de Rosales Cabrera","sequence":"additional","affiliation":[{"name":"Pharmacy Department University Hospital Alcorc\u00f3n Foundation  Alcorc\u00f3n Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Usarralde P\u00e9rez","sequence":"additional","affiliation":[{"name":"Pharmacy Department University Hospital Alcorc\u00f3n Foundation  Alcorc\u00f3n Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Javier","family":"Mart\u00ednez Sim\u00f3n","sequence":"additional","affiliation":[{"name":"Pharmacy Department University Hospital Alcorc\u00f3n Foundation  Alcorc\u00f3n Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"Zhan Zhou","sequence":"additional","affiliation":[{"name":"Pharmacy Department University Hospital Alcorc\u00f3n Foundation  Alcorc\u00f3n Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Sol","family":"Marcos Salazar","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department University Hospital Alcorc\u00f3n Foundation  Alcorc\u00f3n Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"P\u00e9rez Encinas","sequence":"additional","affiliation":[{"name":"Pharmacy Department University Hospital Alcorc\u00f3n Foundation  Alcorc\u00f3n Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Botella Cubells","sequence":"additional","affiliation":[{"name":"CIBER of Rare Diseases National Center  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,25]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"191","article-title":"Optimal management of hereditary hemorrhagic telangiectasia","volume":"5","author":"Garg N","year":"2014","journal-title":"J Blood 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