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Paul B. Kluger, MD, and colleagues, Lahey Clinic, Burlington, Mass, reported using the neodymium-YAG laser in treating a group of 19 patients with hereditary hemorrhagic telangiectasia. Sufficient data were obtained to analyze results in 17 of 19 patients with a follow-up of two months to 3.5 years. Laser power was 20 to 30 W, with exposure settings of 0.2 to 0.5 s. A flexible unfocused quartz fiber inserted through a malleable suction tip was used with the operating microscope for treatment. With the fibertip held approximately 2 cm from the telangiectasias, laser energy was first applied circumferentially around the telangiectasia before direct photocoagulation of each lesion. Local anesthesia with intravenous sedation was used in two thirds of the treatment sessions and standard general anesthesia in the remainder. Postoperative nasal packing was not necessary in most patients, and absorbable hemostatic agents were used when packing was required.
Patients with no history