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Dean A, Estévez O, Centella C, Sanjuan-Sanjuan A, Sánchez-Frías ME, Alamillos FJ. Surgical Navigation and CAD-CAM-Designed PEEK Prosthesis for the Surgical Treatment of Facial Intraosseous Vascular Anomalies. J Clin Med 2024; 13:4602. [PMID: 39200744 PMCID: PMC11354805 DOI: 10.3390/jcm13164602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 07/28/2024] [Accepted: 08/01/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Intraosseous vascular anomalies in the facial skeleton present significant diagnostic and therapeutic challenges due to complex anatomy. These anomalies represent about 0.5-1% of bony neoplastic and tumor-like lesions, usually presenting as a firm, painless mass. Most described intraosseous vascular malformations are venous malformations (VMs) and, more rarely, arteriovenous malformations. Objectives: The objectives of this work are to show our experience, protocol and the applications of computer planning, virtual surgery, CAD-CAM design, surgical navigation, and computer-assisted navigated piezoelectric surgery in the treatment of facial intraosseous vascular anomalies and to evaluate the advantages and disadvantages. Methods: Three females and one male with periorbital intraosseous vascular anomalies were treated using en-block resection and immediate reconstruction with a custom-made PEEK prosthesis. One lesion was in the supraorbital rim and orbital roof, one in the frontal bone and orbital roof, and two in the zygomatic region. We accomplished the resection and reconstruction of the lesion using virtual planning, CAD-CAM design, surgical navigation and piezoelectric device navigation. Results: There were no complications related to the surgery assisted with navigation. With an accuracy of less than 1 mm, the procedure may be carried out in accordance with the surgical plan. The surgeon's degree of uncertainty during deep osteotomies and in locations with low visibility was decreased by the use of the navigated piezoelectric device. Conclusions: Resection and reconstruction of facial intraosseous vascular anomalies benefit from this new surgical strategy using CAD-CAM technologies, computer-assisted navigated piezoelectric surgery, and surgical navigation.
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Affiliation(s)
- Alicia Dean
- Maxillofacial Surgery Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (O.E.); (C.C.); (F.J.A.)
| | - Orlando Estévez
- Maxillofacial Surgery Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (O.E.); (C.C.); (F.J.A.)
| | - Concepción Centella
- Maxillofacial Surgery Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (O.E.); (C.C.); (F.J.A.)
| | - Alba Sanjuan-Sanjuan
- Maxillofacial Surgery Department, Charleston Area Medical Center, Charleston, WV 25301, USA;
| | - Marina E. Sánchez-Frías
- Pathology Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain;
| | - Francisco J. Alamillos
- Maxillofacial Surgery Department, Reina Sofía University Hospital, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (O.E.); (C.C.); (F.J.A.)
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Eder AE, Avila SA, Malenke J, Del Gaudio JM, Wojno T. Intraosseous hemangioma of the orbit: a case report involving pre-operative embolization with reconstruction using a custom porous polyethylene implant. Orbit 2024; 43:516-518. [PMID: 36971116 DOI: 10.1080/01676830.2023.2192778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
A 28-year-old female presented with a slowly enlarging, left cheek mass over two years. She underwent neuroimaging and was found to have a well-defined, low attenuating lesion with thickened vertical trabeculation of the left zygoma, consistent with intraosseous hemangioma. To minimize the risk of severe intraoperative hemorrhage, the patient underwent embolization of the mass by neuro-interventional radiology two days prior to resection. The patient subsequently underwent a left anterior orbitotomy and partial zygoma resection followed by reconstruction of the lateral orbit with a custom porous polyethylene zygomaxillary implant. The postoperative course was uneventful with a good cosmetic outcome.
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Affiliation(s)
- Adrianna E Eder
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sarah A Avila
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jordan Malenke
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John M Del Gaudio
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ted Wojno
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
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Reiss S, Kulker D, Laure B, Paré A. Reconstruction of the orbitozygomatic framework: State of the art and perspectives. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101788. [PMID: 38281701 DOI: 10.1016/j.jormas.2024.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 01/30/2024]
Abstract
The reconstruction of the whole orbitozygomatic framework (OZF) is complex and can be encountered in cases of congenital midface deformity, after tumor ablative surgery and in severe facial trauma. Nowadays, surgeon has a wide range of available techniques that have continually grown over the past years, optimizing the surgical management and the aesthetical outcomes. Among them, the autologous bone graft (ABG) remains one of the most suitable options : ABG is easy to harvest and has optimal biological properties for bone healing. It can be tailored to the patient anatomy thanks to the recent advances in computer-assisted surgery. However, substantial drawbacks remain such as the early resorption of the non-vascularized graft, the need of a donor site and its potential morbidity. Alloplastic reconstruction is another option that can resolve both the resorption issue and the donor site morbidity. Moreover, the 3D-printing technologies also allows the manufacturing of patient specific implants. However, alloplastic materials have a variable success, especially due to the high risk of infection or exposure. Consequently, regenerative medicine is a promising field that aims to find a procedure without the disadvantages of ABG or alloplastic based reconstructions, but displaying similar or even higher success rate. Indeed, recent tissue engineering strategies have demonstrated encouraging results for bone regeneration using natural or synthetic biomaterials, patient cells and synthetic bioactive substances. The objective of this review is to present the etiologies of OZF defect, the available reconstruction procedures as well as the current state of the research.
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Affiliation(s)
- Ségolène Reiss
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Dimitri Kulker
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Boris Laure
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Arnaud Paré
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France.
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Kamboj A, Caruana SM, Winn BJ. Removal of an Intraosseous Venous Malformation of the Maxilla via a Transoral-transconjunctival-Transcaruncular Approach. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5155. [PMID: 37547351 PMCID: PMC10400051 DOI: 10.1097/gox.0000000000005155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/15/2023] [Indexed: 08/08/2023]
Abstract
Intraosseous vascular anomalies represent less than 1% of all bony tumors. When they involve the maxillofacial skeleton, these masses may cause substantial morbidity and aesthetic concern. Herein, we highlight a case of a maxillary intraosseous venous malformation manifesting as functional lacrimal duct obstruction with epiphora, sinus pressure, and increasing medial canthal/maxillary fullness over 2 years in a young, healthy woman. Surgical excision of the lesion was accomplished without a skin incision by coupling a transoral, midface degloving technique with a transconjunctival-transcaruncular approach. This minimally invasive technique led to complete resolution of symptoms and a satisfactory cosmetic outcome, without a cutaneous scar.
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Affiliation(s)
- Alisha Kamboj
- From the Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minn
| | - Salvatore M. Caruana
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian Hospital Columbia University Medical Center, New York, N.Y
| | - Bryan J. Winn
- Department of Ophthalmology, University of California–San Francisco, San Francisco, Calif
- Ophthalmology Section, Surgical Service, San Francisco Veterans Affairs Medical Center, San Francisco, Calif
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Laurian LJ, Decaudaveine S, Caillot A, Walter P, Benichou L. Case report of a zygomatic bone hemangioma surgery with reconstruction by a custom-made implant. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:660-662. [PMID: 35760310 DOI: 10.1016/j.jormas.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/08/2022] [Accepted: 06/23/2022] [Indexed: 11/26/2022]
Abstract
Intraosseous hemangiomas are rare tumors. A 43-year-old woman was referred with a mass in the right zygomatic bone, showing a slow volume increase and pain symptomatology. A surgical management with bone reconstruction using a custom-made implant was decided. Historically, various autografts and alloplastic materials have been used for this type of bone loss. The use of custom-made biomaterials opens new possibilities in maxillofacial reconstructive surgery. The patient showed no symptoms postoperatively and her zygomatic bones were symmetrized. For the authors, this approach seems to be a reliable and reproducible method for zygomatic bone reconstructions.
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Affiliation(s)
- Louis-Joseph Laurian
- hospital practitioner at the Maxillofacial and oral surgery department of the Saint-Joseph hospital, 180 rue cardinet 75017 Paris, France.
| | - Suzanne Decaudaveine
- hospital practitioner at the Maxillofacial and oral surgery department of the Saint-Joseph hospital, 180 rue cardinet 75017 Paris, France
| | - Aude Caillot
- hospital practitioner at the Maxillofacial and oral surgery department of the Saint-Joseph hospital, 180 rue cardinet 75017 Paris, France
| | - Paul Walter
- resident at the Maxillofacial and oral surgery department of the Saint-Joseph hospital, Paris, France
| | - Ludovic Benichou
- head of the Maxillofacial and oral surgery department of the Saint-Joseph hospital, Paris, France
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Fibrous granulation mimicking cranial intraosseous tumor. Radiol Case Rep 2022; 17:2142-2145. [PMID: 35464789 PMCID: PMC9024343 DOI: 10.1016/j.radcr.2022.03.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/03/2022] Open
Abstract
A cranial intraosseous lesion is a rare disease with a limited number of subtypes. We report a case of a cranial intraosseous fibrous granulation that mimicked an intraosseous tumor. A 57-year-old man was incidentally found to have a cranial intraosseous lesion on brain computed tomography. Total resection was performed to establish a pathological diagnosis and to achieve cosmesis, and the pathological diagnosis was fibrosis and fibrous granulation in the medullary cavity. Fibrous granulation tissue occurs in the calvarium due to bone defects secondary to acquired factors, including trauma. Since its pathological diagnosis is established through surgery, surgery should be carefully considered based on the patient's chief complaint, location of the lesion, and suspicion of malignancy based on imaging findings.
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Koh SM, Choi JE, Chung SK, Kim HY. A Case of Intraosseous Hemangioma in the Nasal Cavity. JOURNAL OF RHINOLOGY 2020. [DOI: 10.18787/jr.2020.00315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Osseous hemangioma typically occurs in the vertebral column or skull bones. It it is extremely rare in the nasal bone. Only nine cases originating in the turbinate and maxillary bone have been reported in the English and Korean literature. Herein, we present the case of a 51-year-old women with a dorsum mass to share our experience with intraosseous hemangioma successfully removed and reconstructed by an endonasal approach.
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Large Orbital Pediatric Intraosseous Hemangioma. Case Rep Ophthalmol Med 2020; 2020:5728691. [PMID: 31976106 PMCID: PMC6961600 DOI: 10.1155/2020/5728691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/19/2019] [Indexed: 11/17/2022] Open
Abstract
A five-year-old male presenting with progressive right facial swelling underwent multiple biopsies before being diagnosed with a polyostotic frontal-zygomatic primary intraosseous hemangioma. Intraosseous hemangiomas are rare, more frequently afflict adult females, and very rarely involve the orbit. Our case with bony destruction and surrounding soft tissue mass measured 5.3 cm in a child mimicked a more ominous malignancy. This case is unique with its rapid progression and largest reported size, leading to additional challenges such as difficulty in achieving an adequate tissue sample and in the surgical management with respect to significant blood loss in a small child.
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Temerek AT, Ali S, Shehab MF. Computer guided resection and reconstruction of intra-osseous zygomatic hemangioma: Case report and systematic review of literature. Int J Surg Case Rep 2019; 66:240-256. [PMID: 31874384 PMCID: PMC6931065 DOI: 10.1016/j.ijscr.2019.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/30/2019] [Accepted: 12/10/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES to systemically integrate the available data on various published treatment strategies for intraosseous hemangioma of the zygoma in an updated comprehensive systematic review, and to present a new case of treated resection and immediate reconstruction using computer guided patient specific composite graft. CASE PRESENTATION A 29 years old female patient with intraosseos zygomatic hemangioma treated using computer guided resection and immediate reconstruction. The resection was performed using a resection template constructed based on preoperative 3D planning. The reconstruction was performed using ramus bone graft and titanium mesh. The patient was followed up for 3 years with no complications. METHODS An electronic search was performed on 3 data bases; additional hand search of bibliographies of selected articles was performed. Eligibility criteria include human studies presenting intraosseous zygomatico-orbital hemangioma with clearly reported therapeutic strategies. RESULTS 53 articles with 73 cases were included. The lesion was highly prevalent in females compared to males (2.28:1). Fifth decade represents the highest prevalence with mean age of 44.1 ± 1.8 years. The main patient concern was swelling and facial deformity. Total tumor resection can assure no recurrence, while partial resection and curettage are associated with high recurrence rate.
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Affiliation(s)
- Ahmed Talaat Temerek
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, South Valley University, Qena, Egypt.
| | - Sherif Ali
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Mohamed Farid Shehab
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
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Seo BF, Kang KJ, Jung SN, Byeon JH. Skeletal cavernous hemangiomas of the frontal bone with orbital roof and rim involvement. Arch Craniofac Surg 2018; 19:214-217. [PMID: 30282433 PMCID: PMC6177681 DOI: 10.7181/acfs.2018.01921] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/27/2018] [Indexed: 11/11/2022] Open
Abstract
Skeletal cavernous hemangiomas are rare, benign tumors that may involve the supraorbital rim and orbital roof. However, such involvement is extremely rare. We report a case of skeletal cavernous hemangioma of the frontal bone involving the orbital roof and rim. En bloc excision and reconstruction, using a calvarial bone graft for the orbital roof and rim defect, was performed. It is important not only to perform total excision of skeletal cavernous hemangiomas, but to properly reconstruct the defects after the total excision since several complications can arise from an orbital roof and rim defect.
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Affiliation(s)
- Bommie Florence Seo
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Kyo Joon Kang
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Sung-No Jung
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Jun Hee Byeon
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
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An Algorithm for Managing Intraosseous Vascular Anomalies of the Craniofacial Skeleton. J Craniofac Surg 2018; 29:622-627. [PMID: 29068964 DOI: 10.1097/scs.0000000000004014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Intraosseous vascular anomalies (IOVA) are rare in the craniofacial skeleton and present a diagnostic and therapeutic challenge. This study aims to describe the clinical management based on a large case series. METHODS A retrospective chart review was performed and 9 IOVA were identified over a 15-year period. Data on demographics, diagnostic features, clinical management, and outcomes were reviewed. RESULTS Five frontal bone IOVA and 4 orbital IOVA were identified. The postoperative follow-up ranged from 4 months to 4 years. All 9 lesions were diagnosed with computed tomography (CT) imaging. Magnetic resonance imaging (MRI) was used to delineate soft tissue involvement in 2 patients presenting with oculo-orbital dystopia and ophthalmoplegia. En bloc excision was performed in all patients. Preoperative interventional embolization was critical in the successful resection of an orbital IOVA following 2 previously failed attempts that were aborted secondary to hemorrhage. Intraoperative 3-dimensional stereotactic navigation was used for the accurate en bloc excision of a frontal IOVA to prevent injury to the frontal sinus. Reconstruction of esthetic and functional deformities was successfully accomplished. CONCLUSION The diagnosis of IOVA relies primarily on clinical assessment and CT imaging. Further interpretation of the involvement of periorbital, facial, and intracranial soft tissue is best defined by MRI. Multidisciplinary care with interventional radiology and neurosurgery must be considered for ensuring the safe and adequate en bloc excision of craniofacial IOVA.
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Goto Y, Sasajima H, Furuno Y, Kawabe T, Ohwada K, Yamanaka T, Tatsuzawa K, Hashimoto N. Unusual Presentations of Pediatric Skull Hemangiomas: Report of Two Cases. World Neurosurg 2018; 119:20-24. [PMID: 30075263 DOI: 10.1016/j.wneu.2018.07.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Intraosseous hemangioma is a rare bone tumor, accounting for 0.7%-1.0% of all bone tumors. It can occur at any age, but only 9% of cases are younger than 10 years old. Although this tumor is usually slow-growing and clinically silent, we experienced 2 pediatric patients undergoing surgery for skull hemangioma who presented with uncommon clinical manifestations. CASE DECRIPTION Case 1 was a 9-year-old boy who presented with sudden onset of headache and was referred to our hospital. Radiologic images revealed an osteolytic oval lesion in the right parietal bone and acute subdural hemorrhage in the right cerebral hemisphere. The right parietal lesion was removed surgically. The lesion was found to have grown into the dura and to be adherent to the pia matter. The removed lesion was histologically confirmed to be a hemangioma. Case 2 was an 8-year-old girl who was referred to our hospital with an elastic mass that had been slowly enlarging for 7 years. Radiologic images revealed an osteolytic oval lesion in the right parietal bone. Surgical removal was thus planned. The lesion was found to be attached to the dura, and we removed the lesion with the surrounding bone and attached dura. Histologic examination confirmed the lesion to be a hemangioma. CONCLUSIONS Although skull hemangiomas show clinical heterogeneity, surgical removal is usually diagnostic and leads to good patient outcomes. On occasion, however, this tumor causes secondary changes in the dura, such that dural incision and dural plasty should be planned in advance of lesion removal.
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Affiliation(s)
- Yukihiro Goto
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
| | - Hiroyasu Sasajima
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Yuichi Furuno
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Takuya Kawabe
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Kei Ohwada
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Takumi Yamanaka
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Kazunori Tatsuzawa
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Naoya Hashimoto
- Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medicine Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
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Huang X, An J, Zhang Y, Cai Z. Intraosseous Venous Malformations of the Zygoma: Report of 4 Cases and Literature Review. Ann Otol Rhinol Laryngol 2017; 126:505-509. [PMID: 28376635 DOI: 10.1177/0003489417701934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES As intraosseous venous malformations (IVMs) of the zygoma are very rare and clinical features are not typical, a correct preoperative diagnosis may be difficult to make. This study presents 4 cases of IVM of the zygoma and gives a review of their clinical manifestations, radiographic features, preoperative diagnosis, and differentials. METHODS The report of 4 cases was performed with an average 6-year follow-up. Medical records including clinical, radiographic, and histopathological information were reviewed. RESULTS All the patients were mid-aged women with a complaint of an enlarging mass over the midface. They all failed to receive a definite preoperative diagnosis, and the diagnoses of IVM in all patients were made via pathological evidence. Although they received different surgical treatments, all the follow-up results (2~12 years) were satisfactory. CONCLUSION Intraosseous venous malformations of the zygoma are benign lesions caused by abnormal vessel morphogenesis. Patients usually present in their 40s with a tender or painless swelling of the zygoma. The key to the diagnosis is the typical sunburst pattern of radiating trabeculae with intact cortices on computed tomographic scans. Intraosseous venous malformations should be differentiated from other lesions, including intraosseous meningioma, fibrous dysplasia, osteochondroma, osteosarcoma, and ossifying fibroma.
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Affiliation(s)
- Xiuling Huang
- 1 Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Jingang An
- 1 Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Yi Zhang
- 1 Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Zhigang Cai
- 1 Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
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Powers DB, Fisher E, Erdmann D. Zygomatic Intraosseous Hemangioma: Case Report and Literature Review. Craniomaxillofac Trauma Reconstr 2016; 10:1-10. [PMID: 28210401 DOI: 10.1055/s-0036-1592087] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 04/10/2016] [Indexed: 10/20/2022] Open
Abstract
Intraosseous hemangiomas are uncommon intrabony lesions, representing approximately 0.5 to 1% of all intraosseous tumors. Their description varies from "benign vasoformative neoplasms" to true hamartomatous proliferations of endothelial cells forming a vascular network with intermixed fibrous connective tissue stroma. These commonly present as a firm, painless swelling. Intraosseous hemangiomas present more commonly in females than in males and most likely occur in the fourth decade of life. The most common etiology of intraosseous hemangioma is believed to be prior trauma to the area. They have a tendency to bleed briskly upon removal or biopsy, making preoperative detection of the vascular nature of the lesion of significant importance. There are four variants: (1) capillary type, (2) cavernous type, (3) mixed variant, and (4) scirrhous type. Generally most common in the vertebral skeleton, they can also present in the calvarium and facial bones. In the head, the most common site is the parietal bone, followed by the mandible, and then malar and zygomatic regions. Intraosseous hemangiomas of the zygoma are rare entities with the first case reported in 1950 by Schoenfield. In this article, we review 49 case reports of intraosseous hemangioma of the zygoma, and also present a new case treated with excision followed by polyether-ether ketone implant placement for primary reconstruction.
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Affiliation(s)
- David B Powers
- Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Elda Fisher
- Department of Oral and Maxillofacial Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Detlev Erdmann
- Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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A Case of Reconstruction of Surgical Defect after Removal of Intraosseous Hemangiomas on Nasal Dorsum. ACTA ACUST UNITED AC 2016. [DOI: 10.3342/kjorl-hns.2016.59.2.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Matsumiya T, Nemoto H, Kasai Y, Maruyama N, Sumiya N. Intraosseous venous malformation of the zygoma: A case report and literature review. Int J Surg Case Rep 2015; 12:132-6. [PMID: 26072005 PMCID: PMC4485688 DOI: 10.1016/j.ijscr.2015.04.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 03/20/2015] [Accepted: 04/26/2015] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Venous malformations of the zygoma are rare. Historically, venous malformations have been misrepresented as "hemangiomas". The International Society for the Study of Vascular Anomaly (ISSVA) classification is a reasonable classification that leads to appropriate clinical diagnosis and treatment strategies. Collaboration between surgeons, radiologists, and pathologists is necessary for accurate diagnosis and management. PRESENTATION OF CASE We present here a case of an IOVM in a 59-year-old woman who was treated with a multidisciplinary approach. Superselective arteriography and embolization were effective for diagnosis as well as for prevention of large hemorrhage during surgery. En-bloc resection of the zygoma was performed within hours after embolization and autologous calvarial bone graft was used for primary reconstruction. DISCUSSION We performed a literature review consisting of reviewing 52 cases of IOVM of the zygoma discussing optimal material for reconstruction of the defect for intraosseous venous malformation of the zygoma nationally and internationally. CONCLUSION The combination of surgery and preoperative angiography makes it possible to prevent high risk of hemorrhage. For primary reconstruction of the zygoma, use of autologous calvarial bone can maintain the volume and reconstruct the natural malar contour.
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Affiliation(s)
- Toshie Matsumiya
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan.
| | - Hitoshi Nemoto
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan
| | - Yoshiaki Kasai
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan
| | - Naoki Maruyama
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan
| | - Noriyoshi Sumiya
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan
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Arribas-Garcia I, Alcala-Galiano A, Fernandez Garcia A, Montalvo JJ. Zygomatic intraosseous haemangioma: Reconstruction with an alloplastic prosthesis based on a 3-D model. J Plast Reconstr Aesthet Surg 2010; 63:e451-3. [DOI: 10.1016/j.bjps.2009.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Accepted: 07/23/2009] [Indexed: 10/20/2022]
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Srinivasan B, Ethunandan M, Van der Horst C, Markus AF. Intraosseous 'haemangioma' of the zygoma: more appropriately termed a venous malformation. Int J Oral Maxillofac Surg 2009; 38:1066-70. [PMID: 19574025 DOI: 10.1016/j.ijom.2009.05.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Revised: 11/29/2008] [Accepted: 05/28/2009] [Indexed: 11/28/2022]
Abstract
Vascular anomalies often affect the soft tissues and primary intraosseous lesions are uncommon, with only 33 cases reported in the zygoma. Intraosseous vascular anomalies of the zygoma have traditionally been designated 'haemangiomas' with little attempt to clarify the specific type of the lesion. Recently, specific immunohistochemical markers such as erythrocyte type glucose transporter protein 1 (GLUT-1) have been described to differentiate haemangiomas and vascular malformations. The authors report a case of intraosseous venous malformation of the zygoma and provide supporting evidence to justify the nomenclature. The literature on zygomatic 'haemangiomas' is critically reviewed and the basis for their proper designation as venous malformations highlighted.
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Affiliation(s)
- B Srinivasan
- Department of Oral and Maxillofacial Surgery, Poole, Dorset, UK
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Abstract
Intraosseous hemangiomas are classified as benign tumors of vascular nature. Some authors describe them as hamartomas. They originate and expand inside bone structures. They are usually congenital, rarely of posttraumatic origin. In the Maxillo-Facial Surgery departments of the Universities of Rome "La Sapienza" and "Tor Vergata," from 1990 to 2004, 11 cases of intraosseous hemangioma have been diagnosed. In 6 cases, the neoplasm localized in the zygomatic region; in 3 cases, at the mandible level; in 1 patient, in the maxillary site; and in 1 patient, in the frontal bone. Literature review and the case of a male patient affected by left orbitozygomatic hemangioma are described.
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Gómez E, González T, Arias J, Lasaletta L. Three-dimensional reconstruction after removal of zygomatic intraosseous hemangioma. Oral Maxillofac Surg 2008; 12:159-162. [PMID: 18636281 DOI: 10.1007/s10006-008-0115-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Intraosseous hemangioma, especially in the zygomatic area, is a very rare pathologic condition among the osseous tumors of the head and neck area. Clinical presentation includes a painless mass with progressive growth and hard consistence. Diagnosis is performed by means of computed tomography (CT). Treatment includes radical en bloc surgical excision with healthy bone margins in order to avoid blood loss. Previous embolization is not necessary. Bony defect reconstruction must be performed to avoid secondary deformities. CASE REPORT We present a case report of a 30-year-old female presenting a progressive painless swelling in the malar and zygomatic regions. CT scan demonstrated a right zygomatic lesion that extended into the orbital floor and lateral orbital wall, affecting also the zygomatic arch. The biopsy revealed an intraosseous hemangioma. Treatment was performed including an en bloc resection with healthy bony margins and primary reconstruction with calvarian bone graft in association with galea-pericranium flap.
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Affiliation(s)
- Elena Gómez
- Oral and Maxillofacial Surgery Service, Hospital Universitario La Paz, Madrid, Spain.
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Alves S, Junqueira JLC, de Oliveira EM, Pieri SS, de Magalhães MHCG, Dos Santos Pinto D, Mantesso A. Condylar hemangioma: report of a case and review of the literature. ACTA ACUST UNITED AC 2006; 102:e23-7. [PMID: 17052619 DOI: 10.1016/j.tripleo.2006.04.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Revised: 03/23/2006] [Accepted: 04/07/2006] [Indexed: 11/28/2022]
Abstract
According to the World Health Organization, hemangiomas are benign vasoformative neoplasms or developmental conditions of endothelial origin. The body region is the most commonly affected part of the mandible, and only 4 cases of condylar tumors have been reported in the literature to date. The differential diagnosis between high and low flow vascular lesions is crucial for successful treatment, decreasing the occurrence of serious intraoperative hemorrhage. The clinical, radiographic, and pathological features of an intraosseous vascular lesion in the mandibular condyle in a 22-year-old male are presented, and the differential diagnostic aspects between hemangioma, vascular malformation, and high or low flow lesions are discussed.
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Affiliation(s)
- Sérgio Alves
- Department of Oral Pathology, University of São Paulo School of Dentistry, São Paulo, SP, Brazil
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Abstract
BACKGROUND Hemangiomas arising in the soft tissue are common in the head and neck region, but intraosseous hemangiomas of the facial bone are rare. METHODS The authors conducted a retrospective study investigating the clinical features, management, and outcomes for seven patients with facial bone hemangiomas. RESULTS Three of the hemangiomas arose in the orbital bones, two arose in the mandible, one arose in the frontal bone, and one arose in the zygoma. The mean follow-up was 3 years 9 months. During the first operation, total tumor resection was performed for two symptomatic patients, and partial resection with superficial osteotomy was performed for the remaining five individuals with facial contour deformity. Three patients who underwent partial resection achieved long-term aesthetically satisfactory results without recurrence; the other two developed recurrent tumors and underwent subsequent en bloc resection. No evidence of recurrence was observed in cases where primary or secondary complete tumor resections were performed. CONCLUSIONS Although complete tumor resection represents a definitive treatment for facial bone hemangiomas, conservative partial resection offers a simple method of restoring facial contour with minimal side effects. Although it appears that recurrence cannot be avoided entirely, partial resection should be considered for patients who seek surgery for cosmetic reasons.
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Affiliation(s)
- Nai-Chen Cheng
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital, Taipei
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Affiliation(s)
- Tracey H Stokes
- Division of Plastic, Reconstructive, and Maxillofacial Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
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