Abstract：
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.
摘要：
在难治性疾病如遗传性出血性毛细血管扩张症(HHT)中控制鼻出血的止血程序可能是具有挑战性的。在这份报告中,我们提出了一种用于水下内镜经鼻止血手术的新技术，这是对一名69岁的HHT患者进行的。该患者经历了频繁的鼻出血发作，并且在鼻腔中有许多毛细血管扩张，是出血的原因.使用消融术装置与内窥镜镜片清洁系统相结合有效地治疗了这些毛细血管扩张，该系统提供了盐水以创造稳定的水下条件。这种技术有几个优点，包括提供稳定清晰的内窥镜视野，允许更好的可视化的手术部位。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,重要的是要采取谨慎的预防措施，以防止水进入下气道。有了这个预防措施,该技术对于HHT患者的出血管理特别有用.
