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

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.