Hemostatic procedures for controlling nasal bleeding in refractory diseases such as hereditary hemorrhagic telangiectasia (HHT) can be challenging. In this report, we present a novel technique for underwater endoscopic endonasal hemostatic surgery, which was performed on a 69-year-old man with HHT. The patient had been experiencing frequent episodes of nasal bleeding and had many telangiectasias in the nasal cavity, which were the cause of the bleeding. These telangiectasias were effectively treated using a coblation device in combination with an endoscope lens-cleaning system that supplied saline to create stable underwater conditions. There are several advantages to this technique, including provision of a stable and clear endoscopic field of view, allowing for better visualization of the surgical site. This makes it easier to identify bleeding points and ensure accurate hemostasis. Additionally, the hydrostatic pressure created by the underwater environment helps to reduce bleeding during the procedure. However, it is important to take careful precautions to prevent water from entering the lower airway. With this precautionary measure, this technique is particularly useful in managing bleeding in patients with HHT.

中文翻译：

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结合射频消融和晶状体清洁系统的内窥镜鼻内水下手术在遗传性出血性毛细血管扩张症止血中的作用

对于遗传性出血性毛细血管扩张症 (HHT) 等难治性疾病，控制鼻出血的止血程序可能具有挑战性。在本报告中，我们提出了一种水下内窥镜鼻内止血手术的新技术，该技术是对一名患有 HHT 的 69 岁男性进行的。患者鼻出血频繁，鼻腔内有多处毛细血管扩张，这是导致出血的原因。使用射频消融装置与内窥镜镜片清洁系统相结合，可以有效治疗这些毛细血管扩张，该系统提供盐水以创造稳定的水下条件。这项技术有几个优点，包括提供稳定、清晰的内窥镜视野，可以更好地观察手术部位。这使得更容易识别出血点并确保准确止血。此外，水下环境产生的静水压力有助于减少手术过程中的出血。然而，重要的是要采取仔细的预防措施，防止水进入下呼吸道。通过这种预防措施，该技术对于控制 HHT 患者的出血特别有用。