Role of Sclerotherapy in Treating Oral Vascular Malformations in Hereditary Hemorrhagic Telangiectasia

Otolaryngol Head Neck Surg. 2026 Feb;174(2):579-581. doi: 10.1002/ohn.70088. Epub 2025 Dec 26.

Abstract

Oral telangiectasias in hereditary hemorrhagic telangiectasia (HHT) can significantly impair quality of life. While sclerotherapy is an established treatment for HHT-related epistaxis, it is rarely used for oral telangiectasias. We retrospectively reviewed HHT patients who underwent oral sclerotherapy between 2021 and 2024 at a tertiary academic center. Eleven patients (64% female, mean age 61.3 years, 82% ACVRL1 genotype) underwent sclerotherapy using a 1:4 mixture of 3% sodium tetradecyl sulfate and air. Lesions treated included the lip (36%), tongue (36%), hard palate (18%), and gingiva (9%). Presenting symptoms included oral bleeding with eating and dietary limitations. Adverse effects included transient lip swelling (n = 2) and tongue burning (n = 1). At an average follow-up of 6 months, 10/11 patients with follow-up data had complete symptomatic and clinical resolution. Our findings suggest that oral sclerotherapy is a safe, effective, and minimally invasive treatment for HHT-related oral bleeding that clinicians should consider.

Keywords: HHT; Osler‐Weber‐Rendu syndrome; epistaxis; hereditary hemorrhagic telangiectasia; oral bleeding; oral telangiectasia; sclerotherapy.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Diseases* / etiology
  • Mouth Diseases* / therapy
  • Retrospective Studies
  • Sclerosing Solutions / therapeutic use
  • Sclerotherapy* / methods
  • Sodium Tetradecyl Sulfate / therapeutic use
  • Telangiectasia, Hereditary Hemorrhagic* / complications
  • Telangiectasia, Hereditary Hemorrhagic* / therapy
  • Treatment Outcome
  • Vascular Malformations* / etiology
  • Vascular Malformations* / therapy

Substances

  • Sclerosing Solutions
  • Sodium Tetradecyl Sulfate