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To the Editor: The conclusions of Drs. Stecker and Lake who summarized their experiences with patients suffering from hereditary hemorrhagic telangiectasia are a little different than my own which were derived after observation of 150 patients with the same condition.
First, I find that, for the most part, nosebleeds in patients with hereditary hemorrhagic telangiectasia become steadily worse with advancing age and not less severe as the authors believe. Second, in contrast to their experience, I believe cautery is largely ineffective and the direct cause of further trouble since it renders the nasal mucosa even more friable. Third, I believe the authors may have underestimated the usefulness of estrogens in medical therapy of epistaxis caused by hereditary hemorrhagic telangiectasia. D. N. F. Harrison of England, publishing in the Quarterly Journal of Medicine, January 1964, describes 20 patients who were effectively treated for up to eight years with a daily dosage
William H. Saunders. HEREDITARY HEMORRHAGIC TELANGIECTASIA. Arch Otolaryngol. 1965;82(6):671. doi:10.1001/archotol.1965.00760010673031
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