Xiao Zhang has been bleeding repeatedly from his nasal cavity bilaterally for more than 20 years, and his friends laughingly say that he spurts nosebleeds when he sees a beautiful woman. In the past month, his condition has gradually worsened, with nasal bleeding reaching as many as three times a day, with each bleeding amounting to about 10-30ml, and he felt general weakness. He was later diagnosed with “hereditary capillary dilation”.
Zhang Guanping, chief physician of the Department of Otolaryngology and Head and Neck Surgery at the Sixth Hospital of Sun Yat-sen University, said that after examination, it was confirmed that Zhang was suffering from hereditary capillary dilation, which led to persistent rhinorrhea. This is a rare clinical disease, with an incidence of nearly one in 10,000, mainly manifested by recurrent bleeding and anemia, and there are certain difficulties in the diagnosis and treatment of the disease.
Zhang Guanping introduced that during the nasal endoscopic examination of Xiao Zhang, it was found that there were multiple vascular dilatations in the mucosa of the bilateral nasal septum like spider nevus-like residual tumor, and the blood test indicated “severe anemia” without abnormal coagulation function. It was only after careful questioning of Zhang’s medical history that we learned that Zhang’s father, brothers and children also had recurrent rhinorrhea, which is strong evidence that rhinorrhea may be due to heredity.
Since hereditary capillary dilation is a congenital defect, recurrent rhinorrhea occurs because some of the small arteries, veins and capillaries become thin and cannot contract, thus making them extremely susceptible to bleeding. In order to reduce the symptoms of recurrent bleeding, Zhang was then operated on, using a plasma device to ablate the significantly dilated capillaries in his nasal septal mucosa and other nasal mucosa, allowing for atresia scarring.
Although this surgery was not very difficult, the nasal mucosa of Xiao Zhang was already eroded and edematous in many places. Therefore, every move during the surgery had to be very slight and cautious, as the slightest force could lead to uncontrollable nasal bleeding. After more than two hours on the operating table, multiple vascular dilated areas were finally treated and Xiao Zhang will never have to worry about nasal bleeding again.