Abstract
Vascular malformations in the head and neck encompass a wide range of lesions and present an interesting challenge for the surgeon with their varied presentations. Early diagnosis and timely and adequate intervention help treat patients effectively. We reported our experience in the management of four patients diagnosed with low-flow venous malformation. Every patient was managed differently based on the site and size of the lesion, and all of them had the best outcome. 1 patient who had a smaller lesion was managed with oral propranolol, and 1 patient was managed with oral propranolol with local hot water injection. Two patients had larger lesions involving the airways and hence required an elective tracheostomy because of anticipated airway compromise, following which they were managed with intralesional sclerotherapeutic injection. As the lesion size shrank but remained, both underwent coblator-assisted tumor debulking at the end of two months. All four patients had a better outcome. Each patient received a different modality of treatment. No recurrences were noted in any of them. A multidisciplinary team approach resulted in a positive patient outcome. Vascular lesions should be considered in the differential diagnosis of a patient presenting with increasing dysphagia, dysphonia, or dyspnea. The cooperation of a skilled interventional radiologist cannot be over-emphasized.
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References
Madana J et al (2010) Giant congenital auricular arteriovenous malformation. Auris Nasus Larynx 37:511–514
Wu JK, Bisdorff A, Gelbert F, Enjolras O, Burrows PE, Mulliken JB (2005) Auriculovenous malformation: evaluation, management, and outcome. Plat reconstr Surg 115:985–95
Kobayashi K, Nakao K, Krishishita S et al (2013) Vascular malformations of the head and neck. Auris Nasus Larynx 40:89–92
Pham TH, Wong BJ, Allison G (2001) A large arteriovenous malformation of the external ear in an adult: report of a case and approach to management. Larygoscope 111:1390–4
Thornton BP, Sloan D, Rinker B (2006) Squamous cell carcinoma arising from arteriovenous malformation of the scalp. J Craniofac Surg 17:805–809
Burrows PE, Mulliken JB, Fishman SJ, Klement GL, Folkman J (2009) Pharmacological treatment of a diffuse arteriovenous malformation of the upper extremity in a child. J Craniofac Surg 20(suppl 1):1–5
Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations of infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–422
Fishman SJ, Mulliken JB (1993) Hemangiomas and vascular malformations of infancy and childhood. Pediatr Surg 40:1177–1200
Mulliken JB (1993) Cutaneous vascular anomalies. Semin Vasc Surg 6:204–218
Werner JA, Dünne AA, Folz BJ, Rochels R, Bien S, Ramaswamy A, Lippert BM (2001) Current concepts in the classification, diagnosis and treatment of hemangiomas and vascular malformations of the head and neck. Eur Arch Oto-rhino-laryngology 258:141–149
Enjolras O (1997) Classification, and management of the various superficial vascular anomalies: hemangiomas and vascular malformations. J Dermatol 24:710–710
Kaji N, Kurita M, Ozaki M, Takashima A, Harii K, Kawashima M, Wakita S (2009) Experience of sclerotherapy and embolo- sclerotherapy using ethanolamine oleate for vascular malformations of the head and neck. Scand J Plast Reconstr Surg Hand Surg 43:126–136
Werner JA, Dünne AA, Folz BJ, Rochels R, Bien S, Ramaswamy A, Lippert BM (2001) Current concepts in the classification, diagnosis and treatment of hemangiomas and vascular malformations of the head and neck. Eur Arch Otorhinolaryngol 258:141–149
Kamijo A, Hatsushika K, Kanemaru S, Moriyama M, Kase Y, Masuyama K (2013) Five adult laryngeal venous malformation cases treated effectively with sclerotherapy. The Laryngoscope 123(11):2766–2769
Lee BB, Do YS, Brun HS, Choo IW, Kim DI, Huh SH (2003) Advanced management of venous malformation with ethanol sclerotherapy: mid ter, results. J Vasc Surg 37:533–538
Woods JE (1987) Extended use of sodium tetradecyl sulfate in the treatment of hemangiomas and related conditions. Plast Reconstr Surg 79:542–549
Winter H, Drager E, Sterry W (2000) Sclerotherapy for treatment of hemangiomas. Dermatol Surg 26:105–108
Costa JRS, Torriani MA, Hosni ES, D’Avila OP, de Figueiredo PJ (2011) Sclerotherapy for vascular malformations in the oral and maxillofacial region: treatment and follow-up of 66 lesions. J Oral Maxillofacial Surg 69(6):e88–e92
Rebeiz E, April MM, Bohigian RK, Shapshay SM (1991) Nd-YAG Laser treatment of venous malformations of the head and neck: An update. Otolaryngol-Head Neck Surg 105(5):655–661
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I would like to acknowledge Interventional Radiologist for his support.
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Gowthame, K., Mohanty, S. & Somu, L. Management of Arteriovenous Malformation in Otolaryngology Practice: A Retrospective Study & Review of Literature. Indian J Otolaryngol Head Neck Surg 75, 1323–1328 (2023). https://doi.org/10.1007/s12070-023-03514-w
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DOI: https://doi.org/10.1007/s12070-023-03514-w