Experience with 5% ethanolamine oleate for sclerotherapy of oral vascular anomalies: A cohort of 15 consecutive patients

Sclerotherapy with low-dose 5% ethanolamine oleate in oral vascular anomalies: a retrospective study

OBJECTIVE

To describe the characteristics and outcomes of a cohort of patients with oral vascular anomalies (OVA) treated with sclerotherapy using 5% ethanolamine oleate at a dosage of 0.1 mL per 10 mm of lesion size.

STUDY DESIGN

Sixty-seven patients were selected from a review of 300 medical records of individuals who had been diagnosed with OVA. Clinicodemographic characteristics and treatment outcomes were analyzed descriptively and analytically.

RESULTS

The overall mean number of sclerotherapy sessions required for clinical healing was 1.1, with lesions up to 6 mm typically requiring only one session. The mean volume of 5% ethanolamine oleate administered was 0.1 mL; however, 97.1% of lesions up to 6 mm were successfully treated with a maximum dose of 0.05 mL. Patients with papular lesions had a significantly lower rate of clinical healing compared to those with macular lesions (OR=0.79; [0.64-0.96]; p=.021). The average time to clinical healing was 16.0 days, with lesions up to 6 mm generally healing within 14 days. Complete clinical healing was achieved in 65.7% of cases.

CONCLUSIONS

The low-dose sclerotherapy protocol using 5% ethanolamine oleate is effective for treating OVA, particularly for lesions measuring up to 6 mm in diameter.

Combined Sclerotherapy With Surgical Resection in the Management of Oral Vascular Malformations: A Narrative Review With an Illustrative Two Case Series

Aim

To report a case series of two large VMs treated by sclerotherapy with further surgical resection for aesthetic purposes and discuss its outcomes.

Case Reports

Case 1: Six applications were performed with different volumes (1.5, 0.5, 0.5, 0.5, 0.5 and 0.5 mL, respectively) of Monoethanolamine Oleate (EO) in a VM lesion that affected the buccal mucosa and labial commissure (lesion size: 50 × 33.3 mm), associated with late surgical resection of exceeding cicatricial tissue in a 24‐year‐old female patient. Recurrence occurred after 120 days of follow‐up due to parafunctional suction. Case 2: three applications with different volumes of EO (1.0, 0.8 and 0.8 mL respectively) were performed in an upper lip VM lesion (lesion size: 30 × 40 mm) associated with late surgical resection and cheiloplasty in a 19‐year‐old male patient. Two months of follow‐up showed no signs of recurrence. At the present time, both patients are under observation.

Conclusion

Resolution of VMs can be achieved with different treatment options; especially in arteriovenous VMs, the definitive resolution it is challenging. Recurrence can happen if the main vessel was not achieved by sclerosing agent or if adjuvant parafunction is involved. VMs correct clinical diagnosis and classification is crucial in order to achieve optimal outcomes and prognosis.

Photobiomodulation associated with sclerotherapy for treatment of hemangioma in the hard palate

Vascular changes frequently involve the head and neck region and hemagioma is the most common. A 61-year-old female patient complained of severe pain in the hard palate. A purple lesion was found, measuring 1.5 cm, sensitive to palpation, and with a history of hemorrhage. The patient was fully edentulous and her upper denture compressed the lesion site. Diascopy confirmed the lesion’s vascular origin. A diagnostic hypothesis of hemangioma was raised. In the first session, red laser light (660nm) was applied at 4 points around the lesion, with 0.5 J at each point, in order to obtain analgesia and trigger the repair process. The upper denture was also relined. In the second session, 2 mL of 5% monoethanolamine oleate was applied. After 14 days, total regression of the lesion was observed. Dental surgeons must be able to recognize, diagnose and treat vascular lesions in the oral cavity.

Evaluation of sclerotherapy of benign oral vascular lesions with monoethanolamine oleate

OBJECTIVE

To investigate the efficacy of sclerotherapy with monoethanolamine oleate (MEO) in a series of cases of benign oral vascular lesions (BOVL).

MATERIAL AND METHODS

Clinical records and images were retrieved (2015-2019), and data regarding age, gender, location, size, symptomatology, treatment and outcomes of patients were collected. All patients were diagnosed according to the classification of International Society for the Study of Vascular Anomalies and received the same treatment protocol (MEO 0.05 g/mL). The collected data were submitted to descriptive analysis and Pearson's chi-square test (p ≤ 0.05).

RESULTS

Thirty-seven patients were treated. Most were female (70.3%) aged 9 to 88 years (median, 57.5 ± 17.4 years). Lower lip (54.1%) was the most affected site followed by buccal mucosa (16.2%). Thirty-two lesions were asymptomatic and 35.1% showed ≤ 0.5 cm in size. In 48.6% of the patients, only one application of MEO was performed. Complete regression occurred in 62.2% of cases, whereas 27% showed partial regression. One patient showed hypersensitivity during treatment. There was no significant difference between clinical outcome and age, anatomic site, size, and number of applications of MEO.

CONCLUSIONS

Sclerotherapy with MEO is an acceptable and affordable treatment and can provide satisfactory results in BOVL, especially where other treatment options could compromise the esthetic aspects.

CLINICAL RELEVANCE

As it is a non-invasive therapy leading, in most cases, to adequate clinical results, safety, and tolerability, sclerotherapy with MEO can be considered an effective treatment for BOVL.