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Abstract
INTRODUCTION Appropriate treatment of scalp arteriovenous malformations (SAVMs) remains largely unclear given the rarity of reported cases. This single-institution case series presents consecutive patients with extracranial SAVMs and long-term follow up.The primary aim of this study was to review treatment decisions, evaluate clinical outcomes, and compare our experience to available literature in order to better understand SAVMs and improve future outcomes. MATERIALS AND METHODS A retrospective review of consecutive patients with extracranial SAVMs between January 2015 and December 2019 was performed. Treatment factors of interest included embolization method, embolic agents, and decision to proceed with surgical resection. Relevant clinical outcomes included recurrence rates, cure rates, and complications. RESULTS Seven patients were included in the present series. Satisfactory outcomes were ultimately achieved for all 7 patients using embolization with or without combined surgical resection. Embolizations performed in combination with resection were curative in 4 of 4 cases (100%). Embolizations performed without resection were curative in 0 of 4 cases (0%), satisfactory in 2 of 4 cases (50%), and unsatisfactory in 2 of 4 cases (50%). DISCUSSION All SAVM patients in this series were treated satisfactorily using embolization with or without operative resection. This study strongly suggests that embolization combined with surgical resection during the same admission yields the best treatment outcomes for SAVMs, specifically demonstrating lower rates of recurrence and embolization-related complications. Decisions on whether or not to proceed with resection should be made by the interventional radiologist, the plastic surgeon, and the patient together.
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Larson AS, Brinjikji W, Anderson KR, Tollefson M, Michelle Silvera V, Guerin JB. Imaging of benign cervicofacial vascular anomalies and associated syndromes. Interv Neuroradiol 2021; 28:364-374. [PMID: 34397285 DOI: 10.1177/15910199211034989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Cervicofacial vascular anomalies can result in morbidity, pain, and cosmetic concerns in affected individuals. Each anomaly has its own unique natural history, treatment, and associations with underlying genetic syndromes. For optimal patient care, it is important for the neuroradiologist to accurately recognize and characterize these entities to ensure appropriate treatment and management. In this review, we discuss the general characteristics, classifications, and imaging features associated with the most common vascular anomalies such as hemangiomas, arteriovenous malformations and fistulas, capillary malformations, venous malformations, and lymphatic malformations in the context of associated syndromes. Additionally, we discuss novel imaging techniques that aid in identifying these vascular anomalies.
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Affiliation(s)
| | - Waleed Brinjikji
- Department of Radiology, 6915Mayo Clinic, USA.,Department of Neurosurgery, 6915Mayo Clinic, USA
| | | | - Megha Tollefson
- Department of Dermatology, 6915Mayo Clinic, USA.,Department of Pediatric & Adolescent Medicine, 6915Mayo Clinic, USA
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Pappas DC, Persky MS, Berenstein A. Evaluation and Treatment of Head and Neck Venous Vascular Malformations. EAR, NOSE & THROAT JOURNAL 2019. [DOI: 10.1177/014556139807701110] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Mark S. Persky
- Department of Otolaryngology, Beth Israel Medical Center, New York, New York
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Gopinath M, Malik V, Sankara Sarma P, Rajan JE, Kannath SK. Results of Endovascular-First Approach for Treatment of Scalp Arteriovenous Malformations and the Effect of Simplified Angiographic Classification in Therapeutic Decision-Making and Outcomes. World Neurosurg 2018; 121:e277-e286. [PMID: 30261380 DOI: 10.1016/j.wneu.2018.09.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Scalp arteriovenous malformation (SAVM) is primarily treated by surgery and reports on endovascular treatment are scarce. We report the results of an endovascular-first approach in the treatment of SAVM. We also have proposed a simple dichotomized classification using the angiographically determined morphology findings and discussed its effect on therapeutic decision-making and outcomes. METHODS A consecutive series of 25 patients with SAVM treated by initial or endovascular-only methods were included in the final analysis. The SAVM was categorized as a plexiform or fistulous type according to the angiographic morphology. The demographic data, treatment variables, and final clinical outcomes were analyzed and correlated with the proposed classification. RESULTS Of the 25 patients, 21 were treated with n-butyl cyanoacrylate (n-BCA) and 3 with liquid ethylene vinyl alcohol. One patient had been treated initially with polyvinyl alcohol particles and later with n-BCA. Overall, complete or near complete obliteration (>90%) was achieved in 72%. Surgical excision was performed in 76%, most often after n-BCA embolization. Fistulous-type SAVMs required greater n-BCA concentrations (median, 33% vs. 20%; P = 0.024) and achieved greater rates of complete or near-complete obliteration (90% vs. 63%). Two patients with fistulous-type SAVMs treated with liquid ethylene vinyl alcohol showed complete resolution, and further treatment was not necessary. Overall, regardless of the embolic material used, the fistulous type demonstrated a significantly greater rate of complete obliteration (75% vs. 33%; P = 0.041) compared with plexiform type. CONCLUSION High rates of complete and durable obliteration of SAVM are achievable with endovascular embolization. The proposed simplified classification is easy to implement and can aid in choosing the appropriate embolic agent and predicting the therapeutic outcome.
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Affiliation(s)
- Manoj Gopinath
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Virender Malik
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - P Sankara Sarma
- Achuta Menon Center for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Jayadevan Enakshy Rajan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Santhosh Kumar Kannath
- Achuta Menon Center for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
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Goel V, Verma AK, Singh S, Puri SK. Cirsoid aneurysm of scalp: demonstration on CT angiography (CTA). BMJ Case Rep 2013; 2013:bcr-2013-202459. [PMID: 24336588 DOI: 10.1136/bcr-2013-202459] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Vandana Goel
- Department of Radiology, GB Pant Hospital, New Delhi, India
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6
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Abstract
OBJETIVO: Relatar os resultados da aplicação de técnicas endovasculares no tratamento de aneurismas cirsoideos do couro cabeludo. MATERIAIS E MÉTODOS: Quatro pacientes com diagnóstico de aneurismas cirsoideos foram submetidos ao tratamento por via endovascular. Todos os quatro pacientes incluídos nesta série tinham malformações arteriovenosas e foram tratados apenas com embolização. RESULTADOS: Três pacientes foram submetidos a tratamento endovascular mediante embolização transarterial e um foi tratado por punção direta da porção venosa. Os resultados clínicos e cosméticos foram satisfatórios em todos os pacientes. Não houve recidiva clínica durante o período de acompanhamento. CONCLUSÃO: A via endovascular é uma alternativa segura e eficaz no tratamento dos aneurismas cirsoideos. Embora possa ser efetivamente utilizado como uma alternativa adjuvante ou complementar à cirurgia, especialmente quando é necessário lidar com aferências profundas, a maioria dos casos pode ser totalmente curada apenas com a terapêutica endovascular. A escolha do método de tratamento deve ser baseada em uma variedade de características próprias da lesão, incluindo sua angioarquitetura, tamanho e apresentação clínica.
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7
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Cappabianca S, Del Vecchio W, Giudice A, Colella G. Vascular malformations of the tongue: MRI findings on three cases. Dentomaxillofac Radiol 2006; 35:205-8. [PMID: 16618856 DOI: 10.1259/dmfr/75347689] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Vascular malformations are common lesions accounting for approximately 7% of all benign tumours, the majority of which develop in the head and neck region. Generally, vascular malformations such as lymphangiomas, haemangiomas, and arteriovenous communications in the head and the neck represent only an aesthetic problem. However, when localized in the tongue, these lesions can create clinical problems consisting, in the majority of cases, in spontaneous haemorrhage from the mouth. Although uncommon, progressive asymmetric growth of the tongue (macroglossia) can be also observed. Three consecutive cases of vascular malformations of the tongue have been studied with magnetic resonance imaging (MRI). Neither contrast medium administration nor angio-MR technique was used. In our experience, MR appears to be the ideal technique to define the site, extension and origin of vascular malformations, due to its ability to depict the typical signal flow voids in the lesions and to differentiate slow-flow lesions from high-flow ones.
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Brusati R, Galioto S, Biglioli F, Goisis M. Conservative treatment of arteriovenous malformations of the mandible. Int J Oral Maxillofac Surg 2001; 30:397-401. [PMID: 11720041 DOI: 10.1054/ijom.2001.0120] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A modified technique is reported on the treatment of arteriovenous malformations in the mandibular body. The technique consists of highly selected embolization and piecemeal removal of the lesion through burred holes made in the cortex. This way the mandible and the teeth may be saved in selected patients.
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Affiliation(s)
- R Brusati
- Department of Maxillo-Facial Surgery, San Paolo University Hospital, Milan, Italy
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9
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Williams EF, Stanislaw P, Dupree M, Mourtzikos K, Mihm M, Shannon L. Hemangiomas in infants and children. An algorithm for intervention. ARCHIVES OF FACIAL PLASTIC SURGERY 2000; 2:103-11. [PMID: 10925435 DOI: 10.1001/archfaci.2.2.103] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Considerable confusion exists with the diagnosis and management of vascular birthmarks. For this article we reviewed charts for the diagnosis and recommended management of 208 new patients with vascular birthmarks presenting to the Albany Medical Center Vascular Malformation Clinic, Albany, NY, over a 26-month period from October 1995 through December 1997. Based on our patient population, data available, and the current literature, we concluded that an early evaluation and an accurate diagnosis in infants with a vascular birthmark are important. Furthermore, intervention by way of systemic steroids, laser therapy, or surgical debulking is appropriate and safe in a select group of patients presenting with a proliferating hemangioma and in patients with an involuting but disfiguring hemangioma. Also in this article we present an algorithm to assist the clinician with the management of the pediatric patient with a diagnosis of a hemangioma.
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10
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De Riu G, Sanna MP. Mandibular arteriovenous malformation in pregnancy. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1999; 87:396-7. [PMID: 10225619 DOI: 10.1016/s1079-2104(99)70258-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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11
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Rudman RA, Clark WJ. A large vascular malformation of the tongue treated with radiation therapy. J Oral Maxillofac Surg 1997; 55:509-14. [PMID: 9146522 DOI: 10.1016/s0278-2391(97)90704-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- R A Rudman
- Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville 32610, USA
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Schneider C, Wagner A, Hollmann K. Treatment of intraosseous high flow arteriovenous malformation of the mandible by temporary segmental ostectomy for extracorporal tumour resection: a case report. J Craniomaxillofac Surg 1996; 24:271-5. [PMID: 8938507 DOI: 10.1016/s1010-5182(96)80057-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
We present a case of intraosseous arteriovenous malformation of the mandible with temporary segmental resection, extracorporal removal of the vascular malformation from the osteotomized mandibular bone and intraoperative osteosynthetic replantation of the avascular bony remnant. In a follow-up after 1 year, when removing the titanium miniplates used for osteosynthesis, the mandibular bone was found to have remodelled completely. There is no recurrence of the lesion in a follow-up after 2 years.
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Affiliation(s)
- C Schneider
- Clinic of Maxillofacial Surgery, University of Vienna, Austria
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13
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Nagasaka S, Fukushima T, Goto K, Ohjimi H, Iwabuchi S, Maehara F. Treatment of Scalp Arteriovenous Malformation. Neurosurgery 1996. [DOI: 10.1227/00006123-199604000-00007] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Susumu Nagasaka
- Department of Neurosurgery, School of Medicine, Fukuoka University, Fukuoka
| | - Takeo Fukushima
- Department of Neurosurgery, School of Medicine, Fukuoka University, Fukuoka
| | - Katsuya Goto
- Department of Interventional Neuroradiology, Iizuka Hospital, Iizuka
| | - Hiroyuki Ohjimi
- Division of Plastic Surgery, Department of Orthopedics, School of Medicine, Fukuoka University, Fukuoka
| | - Satoshi Iwabuchi
- Department of Interventional Neuroradiology, Iizuka Hospital, Iizuka
| | - Fumiaki Maehara
- Department of Radiology, Hitoyoshi General Hospital, Hitoyoshi, Japan
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14
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15
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Abouzgia MB, Symington JM. Recurrent arteriovenous malformation of the mandible: a case report. J Oral Maxillofac Surg 1992; 50:1230-3. [PMID: 1403282 DOI: 10.1016/0278-2391(92)90161-r] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- M B Abouzgia
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Toronto, Ontario, Canada
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Abstract
Spontaneous bleeding from the molar gingiva may reflect the presence of a life-threatening vascular malformation. Sporadic reports of exsanguinating hemorrhage in the dental literature warn of the dangers of extraction, although deaths from unrecognized lesions or secondary to mandibular fracture still occur. Arteriovenous malformation (AVM) may be either unilateral or, less commonly, bilateral, and should be suspected in individuals with large lower facial hemangiomata. Two cases of near-exsanguinating hemorrhage from bilateral AVMs are discussed with the long-term management over a 3- to 20-year follow-up. The report underscores the failure of therapeutic embolization and the need for computed tomographic scanning as a corollary to angiography. A newer treatment with direct removal of the AVM and obliteration methods solves the hemorrhagic complications, reduces the potential for steal syndromes, and reduces the potential for recurrence.
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Affiliation(s)
- R A Sofferman
- Section of Otolaryngology, University of Vermont College of Medicine, Burlington
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17
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Hiatt SW, Shannon MT, Mustoe TA, Sclaroff A. Management of a mandibular high-flow vascular malformation. J Oral Maxillofac Surg 1989; 47:295-9. [PMID: 2646407 DOI: 10.1016/0278-2391(89)90235-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A case of a high-flow mandibular vascular malformation successfully treated with combined selective embolization, resection, and reconstruction is reported.
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Affiliation(s)
- S W Hiatt
- Department of Oral and Maxillofacial Surgery, Washington University School of Dental Medicine, St. Louis, MO 63110
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18
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Brunelle FO, Chaumont P, Teillac D, Manach Y, Lallemand D. Facial vascular malformations in children. Conventional and digital, diagnostic and therapeutic angiography. Pediatr Radiol 1988; 18:377-82. [PMID: 3174277 DOI: 10.1007/bf02388039] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The authors present their experience with conventional and digital angiography of vascular malformations of the head and neck in children. 22 hemangioendotheliomas, 8 venous angiomas, and 3 arteriovenous fistula were studied. 22 patients were embolised. DSA offers many advantages during the diagnostic as well during the therapeutic phase of angiography. Embolization appears to have a major role in treatment of such vascular malformations.
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Affiliation(s)
- F O Brunelle
- Department of Pediatric Radiology, Hôpital des Enfants Malades, Paris, France
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19
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Simpson RK, Fischer DK, Haber LM, Mawad ME, Rose JE. Coexistence of multiple arteriovenous malformations and an anomalous aortic arch. Clin Neurol Neurosurg 1988; 90:169-73. [PMID: 3208472 DOI: 10.1016/s0303-8467(88)80041-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
An unusual case of multiple congenital arteriovenous malformations (AVM) coexistent with an anomalous aortic arch is described. Our patient had been asymptomatic, with physical findings limited to a low grade systolic murmur, until the onset of acute subarachnoid hemorrhage. Arteriography was technically difficult and failed to demonstrate the origin of his hemorrhage or the configuration of his aortic arch. However, an AVM within the neck muscles was visualized. Magnetic resonance imaging of his chest revealed a right-sided, retroesophageal aortic arch with an anomalous pattern of branching. The intracranial AVM and the course of the great vessels was clearly revealed at autopsy. A possible embryologic mechanism underlying the origin and distribution of the arch vasculature is discussed.
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Affiliation(s)
- R K Simpson
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas 77030
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21
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Shikhani AH, Shehadi SI. Surgical treatment of giant hemangiomas of the head and neck. Otolaryngol Head Neck Surg 1986; 94:113-22. [PMID: 3081847 DOI: 10.1177/019459988609400118] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This article is a review of 22 cases of giant hemangiomas of the head and neck treated at the American University of Beirut Medical Center over a 20-year period 1964 to 1984. All these cases were treated by surgical excision. Two maneuvers designed to reduce blood loss during the operation are described: the placement of strangulating silk sutures around the periphery of the hemangioma, and temporary occlusion of the ipsilateral external carotid artery. These cases were studied as to age, sex, site, size of hemangioma, histopathologic characteristics, mode of treatment, and results. A review of the literature and current modes of treatment of hemangiomas of the head and neck is also presented and our results are compared with those in other published reports. The surgical approach as a primary and definitive treatment for these giant hemangiomas is emphasized.
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Persky MS, Berenstein A, Cohen NL. Combined treatment of head and neck vascular masses with preoperative embolization. Laryngoscope 1984; 94:20-7. [PMID: 6690874 DOI: 10.1002/lary.5540940105] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Recent advances with aggressive vascular radiologic techniques have altered the methods of treatment of head and neck vascular malformations. High resolution CT scanning and superselective angiography with subtraction technique is now capable of defining the extent of these lesions and demonstrating blood flow dynamics. Careful joint evaluation by the vascular radiologist and the head and neck surgeon is necessary for the proper treatment of these patients. Preoperative embolization of these lesions effectively reduces intraoperative blood loss and provides for better exposure in those patients ultimately undergoing resection of these masses. Careful selection of those cases that are amenable to total or subtotal excision, with adherence to specific criteria and goals, usually produces gratifying results. We present five patients who have undergone combined treatment of their head and neck vascular lesions. Our treatment protocol is reviewed and emphasis is placed on the integral part that the vascular radiologist assumes in the treatment of these patients.
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Zou ZJ, Wu YT, Sun GX, Zhu XP, Meng XZ, He ZQ. Clinical application of angiography of oral and maxillofacial hemangiomas. Clinical analysis of seventy cases. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1983; 55:437-47. [PMID: 6575331 DOI: 10.1016/0030-4220(83)90226-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Angiographic findings in seventy cases of maxillofacial hemangioma are reported. The tumors have been divided into four types: (1) plexiform hemangioma, (2) cavernous hemangioma with venous drainage, (3) cavernous hemangioma without venous drainage, and (4) the so-called "diffuse type" of cavernous hemangioma. The angiographic features of the four types are described, and clinical application is evaluated. The angiograms demonstrate the location, extent, blood supply, and drainage of the tumors and show whether they communicate intracranially, thus providing valuable criteria for planning and determining the mode of treatment.
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Leipzig B, Yau PC. Massive congenital arteriovenous malformation of the pterygomaxillary space. Otolaryngol Head Neck Surg 1982; 90:48-51. [PMID: 6806756 DOI: 10.1177/019459988209000109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A case is presented of a massive congenital, extracranial arteriovenous malformation (AVM). The origins and hemodynamic considerations that led to prior treatment failure are discussed. A sudden accelerated growth in the AVM, caused by an alteration in the hemodynamics of the feeding and draining vessels, mandated further surgical management. The treatment of choice is complete surgical excision at the time of diagnosis, if possible. Ligation of the feeding vessels alone is unsatisfactory and, like other adjunctive treatments, may lead to disastrous complications.
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Biller HF, Krespi YP, Som PM. Combined therapy for vascular lesions of the head and neck with intra-arterial embolization and surgical excision. Otolaryngol Head Neck Surg 1982; 90:37-47. [PMID: 6806755 DOI: 10.1177/019459988209000108] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Anderson JH, Grisius RJ, McKean TW. Arteriovenous malformation of the mandible. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1981; 52:118-25. [PMID: 6943478 DOI: 10.1016/0030-4220(81)90306-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Large intraosseous arteriovenous malformations (AVM) of the mandible are rare lesions. A review of the American literature has revealed sixty cases involving the mandible. This article presents a case of left mandibular AVM in which the initial treatment was embolization. Eventually, however, an emergency hemimandibulectomy became necessary. Postoperative physiotherapy is considered an important part of the treatment in patients who have undergone hemimandibulectomy. An unusual feature in this case has been the amount of spontaneous regeneration of bone in the surgical site.
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Abstract
Long-term follow-up is essential to evaluate our present modalities of treatment of arteriovenous malformations of the maxillae. Embolization followed by surgical resection has produced long-term survival in our patient population.
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Orbach S. Congenital arteriovenous malformations of the face. Report of a case. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1976; 42:2-13. [PMID: 1065837 DOI: 10.1016/0030-4220(76)90025-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Arteriovenous malformations (AVM) are uncommon vascular abnormalities which can be either developmental defects present from birth, or acquired ones, secondary to trauma. They may cause local swelling and discomfort, and also may present a potential for severe bleeding. Traumatic AVM are usually single fistulous channels, whereas congenital lesions are most often multiple interconnections of vessels of varying caliber that result in a diffuseness which renders clini-al delineation and treatment difficult. The nature of the lesion is determined by the stage of development of the vascular system during which it develops. Congenital lesions range from finely channelled capillary hemangiomas to large-bore, high-flow A-V fistulas. Most lesions are not observed at birth, but become manifest later in life; minor trauma and endocrine change are implicated as the stimuli for the initiation of hemodynamic activity. The diagnosis is clinical, with confirmation by arteriography. The treatment has not been completely satisfactory in all cases. Surgical intervention has been used most often, but newer techniques include cryotherapy and muscle embolization.
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