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Derquenne A, Anquetil M, Desal H, Bertin H. Classical radiolucent lesion of the mandible in a child, uncommon diagnosis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101932. [PMID: 38823481 DOI: 10.1016/j.jormas.2024.101932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 05/18/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024]
Affiliation(s)
- Amaury Derquenne
- Nantes Université, CHU Nantes, Service de chirurgie maxillo-faciale et stomatologie, F-44000 Nantes, France.
| | - Marine Anquetil
- Nantes Université, CHU Nantes, Service de chirurgie maxillo-faciale et stomatologie, F-44000 Nantes, France
| | - Hubert Desal
- Nantes Université, CHU Nantes, Neuroradiologie diagnostique et interventionnelle, F-44000 Nantes, France; Nantes Université, INSERM UMR 1087, Institut du thorax, F-44000 Nantes, France
| | - Hélios Bertin
- Nantes Université, CHU Nantes, Service de chirurgie maxillo-faciale et stomatologie, F-44000 Nantes, France; Nantes Université, Univ Angers, CHU Nantes, INSERM, CNRS, CRCI2NA, F-44000 Nantes, France
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2
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Ethunandan M. Management of Midfacial and Skull Vault Osseous Vascular Lesions. Oral Maxillofac Surg Clin North Am 2024; 36:61-72. [PMID: 37821289 DOI: 10.1016/j.coms.2023.09.007] [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] [Indexed: 10/13/2023]
Abstract
There continuous to be widespread misuse of nomenclature used to described vascular anomalies, This is even more pronounced in the case of intra-osseous lesions. Bone involvement is more common with vascular malformations and extremely rare in haemangiomas. An accurate diagnosis is mandatory for tailored management and often based on a thorough history, clinical examination, and cross-sectional imaging. Surgery remains the main stay for the management of symptomatic venous malformations. Embolisation with or without surgery is the main stay for arteriovenous malformations. Virtual surgical planning, with surgical guides and patient specific implants help achieve predictably excellent results.
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Affiliation(s)
- Madan Ethunandan
- Oral & Maxillofacial Surgery, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK; Oral & Maxillofacial Surgery, Sri Ramchandra Institute of Higher Education and Research, Prour, Chennai, 600116, India.
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Ciccarese F, Chauvel-Picard J, Guibaud L, Viremouneix L, Perrot JL, Breton P, Gleizal A. Management of intra-osseous arteriovenous malformations of the mandible. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e544-e548. [PMID: 35272090 DOI: 10.1016/j.jormas.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/15/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Intra-mandibular arteriovenous malformations (IM-AVM) are rare congenital lesions sadly known by the appearance of cataclysmic haemorrhages. It represents a therapeutic challenge which requires a multidisciplinary approach. This paper aims to evaluate the characteristics and management of IM-AVM through the illustration of six case reports, the largest serie in the literature to our knowledge. This retrospective study included all patients with IM-AVM treated in the hospital of Lyon and Saint-Etienne between 1982 and 2021, in France. The management of mandibular AVMs should be individualized and permanently adjusted according to their stage of development, which makes their management difficult. Furthermore, long-term follow-up is essential to detect and manage the subclinical progression of the lesion. Based on these results and a systematic review of the literature, an algorithm has been developed to guide the treatment strategy for this are pathology.
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Affiliation(s)
- Fanny Ciccarese
- Department of Cranio-Maxillo-Facial Surgery, Hôpital Nord, Avenue Albert Raimond 42055 Saint-Etienne Cedex, France; Jacques Lisfranc faculty of Medicine, Jean Monnet University, Saint-Etienne, France.
| | - Julie Chauvel-Picard
- Department of Cranio-Maxillo-Facial Surgery, Hôpital Nord, Avenue Albert Raimond 42055 Saint-Etienne Cedex, France; Jacques Lisfranc faculty of Medicine, Jean Monnet University, Saint-Etienne, France; Department of Cranio-Maxillo-Facial Surgery of the pediatric hospital, Hôpital Femme Mère Enfant, 59 boulevard Pinel, 69677 Bron, France
| | - Laurent Guibaud
- Department of Pedriatric and Fetal Imaging, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69500 Bron, France; Claude Bernard Lyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France
| | - Loïc Viremouneix
- Department of Pedriatric and Fetal Imaging, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69500 Bron, France; Claude Bernard Lyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France
| | - Jean-Luc Perrot
- Jacques Lisfranc faculty of Medicine, Jean Monnet University, Saint-Etienne, France; Department of dermatology, Hôpital Nord, Avenue Albert Raimond 42055 Saint-Etienne Cedex, France
| | - Pierre Breton
- Claude Bernard Lyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France; Department of Cranio-Maxillo-Facial Surgery, Centre Hospitalier Lyon Sud, 165 chemin du Grand Revoyet, 69310 Pierre-Bénite, France
| | - Arnaud Gleizal
- Department of Cranio-Maxillo-Facial Surgery, Hôpital Nord, Avenue Albert Raimond 42055 Saint-Etienne Cedex, France; Department of Cranio-Maxillo-Facial Surgery of the pediatric hospital, Hôpital Femme Mère Enfant, 59 boulevard Pinel, 69677 Bron, France; Claude Bernard Lyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France
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Systematic review of pediatric mandibular arteriovenous malformations. Int J Pediatr Otorhinolaryngol 2021; 150:110942. [PMID: 34673419 DOI: 10.1016/j.ijporl.2021.110942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 09/28/2021] [Accepted: 10/12/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The management of arteriovenous malformations (AVMs) can be challenging in the pediatric population. It is of utmost importance to keep in mind various management options as these lesions can have disastrous outcomes. This is a systematic review of the treatment AVMs describing the current practices so that practitioners can be aware of what is currently reported in the literature. The challenges of AVM management can be mitigated when approaching these patients through a multidisciplinary team-based approach. METHODS A systematic review of the literature was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to gain insight into pediatric mandibular AVMs. Demographics, arterial involvement, clinical symptoms, imaging, treatment, complications, follow-up, and outcomes were reviewed. RESULTS 63 articles were included in the systematic review with 106 distinct cases. The age range was from 3 to 17 years with a mean of 12 years. 51% of the patients were female. The most common clinical presentation was emergency hemorrhage (37.4%), swelling or edema (33.0%), and persistent bleeding (31.9%). The most common CT findings were osteolytic changes and radiolucencies (60.8%). With regards to treatment, 56.6% of patients had embolization alone and 34.9% were treated with embolization in combination with other surgical treatments. Of the patients who had surgical resection of the lesion, 50% had resection followed by reconstruction, 23.7% had curettage of the lesion, and 13.2% had resection/curettage then immediate reimplantation of the mandible segment. The most common complications after intervention included bleeding in 17.9% of patients and infection in 8.3% of patients. 89.5% of patients were clinically cured without recurrence at follow-up. CONCLUSION Diagnosing AVMs can be difficult as they have variable clinical and radiographical presentations. Although rare, because of risk of massive hemorrhage, it is important for healthcare professionals to be aware of this pathology. Many surgical techniques, routes of embolization, embolic material, and other experimental therapies have been described and this review shows that the most cases had embolization as a part of the treatment. The role of therapies targeted at the molecular level still needs to be further explored.
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Ravula P, Rangachari S, Susarla R, Sambari L, Jammula SS. Primary free fibula reconstruction in life-threatening haemorrhage from high flow arteriovenous malformation of mandible. Indian J Plast Surg 2018; 51:222-230. [PMID: 30505095 PMCID: PMC6219352 DOI: 10.4103/ijps.ijps_13_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: High flow arteriovenous malformation (AVM) of the mandible is rare, but it can present as a life-threatening emergency with severe intraoral bleeding for the first time. The gold standard of treatment for an AVM of the mandible is selective embolisation combined with resection and subsequent reconstructions. With the advent of advanced multidisciplinary techniques aimed at definitive therapy, surgical resection and primary reconstruction can provide an ideal anatomical and functional cure. There are no previous reports on primary resection and reconstruction for life-threatening haemorrhage from high flow AVM of the mandible. Aim: We discuss our approach aimed at definitive therapy in life-threatening intraoral bleeding from large high flow AVM of the mandible. Subjects and Methods: Four patients were managed for life-threatening intraoral bleeding during 2015–2017. Compression was applied over the bleeding point before the airway could be secured by endotracheal tube. Under general anaesthesia, the external carotid artery (ECA) was temporarily occluded using an umbilical tape loop ligature to control the bleeding. Emergency selective embolisation was done, followed by curative resection and primary mandible reconstruction using free fibula flap. Outcome assessed. Results: Temporary occlusion of the ECA successfully controlled the bleeding immediately and facilitated selective embolisation and definitive therapy. All the four cases were successfully reconstructed with a good outcome. There was no recurrence during the follow-up period. Conclusion: In life-threatening intraoral bleeding from large high flow AVM of the mandible, emergency selective embolisation followed by curative resection and primary reconstruction is safe in achieving an ideal cure.
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Affiliation(s)
- Parvathi Ravula
- Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Srikanth Rangachari
- Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Rammurti Susarla
- Department of Radiology, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Laxman Sambari
- Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Srinivas Saraswathi Jammula
- Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
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Kaderbhai J, Breik O, Heggie AA, Penington AJ. High-flow paediatric mandibular arteriovenous malformations: case reports and a review of current management. Int J Oral Maxillofac Surg 2017; 46:1650-1655. [PMID: 28705626 DOI: 10.1016/j.ijom.2017.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/02/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022]
Abstract
High-flow vascular malformations in the paediatric population are potentially life-threatening and are challenging to treat. This paper describes the management of three cases of mandibular arteriovenous malformations and reviews the contemporary management options for these serious lesions.
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Affiliation(s)
- J Kaderbhai
- Oral and Maxillofacial Unit, Department of Plastic and Maxillofacial Surgery, The Royal Children's Hospital of Melbourne, Australia
| | - O Breik
- Oral and Maxillofacial Unit, Department of Plastic and Maxillofacial Surgery, The Royal Children's Hospital of Melbourne, Australia
| | - A A Heggie
- Oral and Maxillofacial Unit, Department of Plastic and Maxillofacial Surgery, The Royal Children's Hospital of Melbourne, Australia.
| | - A J Penington
- Oral and Maxillofacial Unit, Department of Plastic and Maxillofacial Surgery, The Royal Children's Hospital of Melbourne, Australia
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Su L, Wang D, Han Y, Wang Z, Fan X. Salvage treatment of hemorrhagic arteriovenous malformations in jaws. J Craniomaxillofac Surg 2015; 43:1082-7. [PMID: 26154397 DOI: 10.1016/j.jcms.2015.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 04/17/2015] [Accepted: 06/08/2015] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To present our clinical experience on embolotherapy of arteriovenous malformations (AVMs) in jaws with acute hemorrhage. MATERIALS AND METHODS Twelve patients with a history of hemorrhage were selected for this study. Continuous interdental sling suture, digital pressure on the extraction socket, and iodoform gauze packed into the socket and fixed with sutures to the adjacent gum were used for temporary hemostasis before embolization. Fiberoptic bronchoscopy was used in all cases to facilitate endotracheal intubation. Absolute ethanol combined with coils was used as method of embolization. RESULTS Eight patients presented with intermittent interdental gum bleeding or controlled hemostasis before embolization. Four patients presented with torrential hemorrhage around the tooth, controlled by continuous pressure on the tooth and bilateral gum for temporary hemostasis. All patients were successfully salvaged before embolization. Ten of 12 patients were cured, and 2 had partial remission. Follow-up ranged from 12 to 26 months (mean, 16.5 months) for all patients, and there was no recurrence of the lesions. CONCLUSIONS The treatment of hemorrhagic AVMs of the jaw requires a multidisciplinary team approach; such cases can be successfully salvaged and stably controlled by embolization with coils and absolute ethanol.
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Affiliation(s)
- Lixin Su
- Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Deming Wang
- Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yifeng Han
- Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenfeng Wang
- Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xindong Fan
- Department of Interventional Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Theologie-Lygidakis N, Schoinohoriti O, Tzermpos F, Christopoulos P, Iatrou I. Management of Intraosseous Vascular Malformations of the Jaws in Children and Adolescents: Report of 6 Cases and Literature Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2015; 6:e5. [PMID: 26229584 PMCID: PMC4516857 DOI: 10.5037/jomr.2015.6205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/06/2015] [Indexed: 11/16/2022]
Abstract
Background Intraosseous vascular malformations represent a rare clinical entity of the facial skeleton. The purpose of the current study was to present our experience in a Greek paediatric population and propose guidelines for the treatment of these jaws anomalies in children and adolescents. Methods A retrospective study (from 2009 to 2014) was performed to investigate the features and management of the intraosseous vascular anomalies in a Greek paediatric population. Results Six patients aged between 6 and 14 years were treated for intraosseous vascular malformations (4 venous and 2 arteriovenous) of the jaws. Five lesions were located in the mandible and one in the maxilla. In four lesions with pronounced vascularity superselective angiography, followed by embolization was performed. Individualized surgical treatment, depending on the size and vascularity of the lesions was applied in 4 patients. Conclusions The intraosseous vascular malformations of the jaws may escape diagnosis in paediatric patients. A multidisciplinary approach is important for their safe and efficient treatment. Embolization is recommended for extended high-flow lesions, either preoperatively or as a first-line treatment, when surgery is not feasible without significant morbidity.
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Affiliation(s)
- Nadia Theologie-Lygidakis
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
| | - Ourania Schoinohoriti
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
| | - Fotios Tzermpos
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
| | - Panos Christopoulos
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
| | - Ioannis Iatrou
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
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Gingival bleeding of a high-flow mandibular arteriovenous malformation in a child with 8-year follow-up. Case Rep Pediatr 2015; 2015:745718. [PMID: 25893127 PMCID: PMC4381677 DOI: 10.1155/2015/745718] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 02/25/2015] [Indexed: 11/18/2022] Open
Abstract
Intraosseous arteriovenous malformations (AVMs) in the head and neck region are uncommon. There are several types and they can have a wide range of clinical presentations. Depending on the blood flow through the AVM, the treatment may be challenging for the attending team and may lead to life-threatening hemorrhages. A clinical case report is presented. A 9-year-old girl, seen for gingival bleeding during oral hygiene, was found to have a high-flow AVM located within and around the mandible. Two-stage treatment consisted of intra-arterial embolization followed by intraoral injection of a sclerosing agent 8 weeks later. At the 8-year follow-up, imaging study showed no evidence of recurrent lesion inside or outside the bone. The final outcome is a correct occlusion with a symmetric facial result. This case shows that conservative treatment may be the first treatment option mostly in children. Arteriography and transcortical injection were enough to control the AVM.
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Colletti G, Frigerio A, Giovanditto F, Biglioli F, Chiapasco M, Grimmer JF. Surgical Treatment of Vascular Malformations of the Facial Bones. J Oral Maxillofac Surg 2014; 72:1326.e1-18. [DOI: 10.1016/j.joms.2014.02.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 02/01/2014] [Indexed: 11/26/2022]
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11
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Extensive bilateral arteriovenous malformations of the mandible successfully controlled by combined endovascular and transcutaneous angio-embolization: case report and review of the literature. Int J Pediatr Otorhinolaryngol 2013; 77:130-6. [PMID: 23031179 DOI: 10.1016/j.ijporl.2012.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/06/2012] [Accepted: 09/07/2012] [Indexed: 11/20/2022]
Abstract
We report a unique case of extensive bilateral arteriovenous malformation (AVMs) in a child's mandible, discuss treatment options and review literature. A healthy 8 year-old girl presented with bright blood of unknown source found on her pillow. Three large AVMs involving the symphyseal region and bilateral mandibular bodies were found on angiography. Due to the extent of surgical resection required, the patient underwent a series of endovascular and transcutaneous angio-embolization. In cases of extensive intraosseous AVMs, serial embolization procedures can be successful in controlling episodes of hemorrhage and allow for bone remineralization. A multidisciplinary approach by otolaryngologists and neurointerventional radiologists can optimize the results.
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Large arteriovenous malformation of the oromaxillofacial region with multiple phleboliths. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:e147-58. [PMID: 22986253 DOI: 10.1016/j.oooo.2012.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 04/20/2012] [Accepted: 05/14/2012] [Indexed: 11/20/2022]
Abstract
Vascular tumors are the most common benign tumors of the head and neck in infancy and childhood. Vascular anomalies of the head and neck were divided into 2 categories including hemangiomas and vascular malformations. Oral and maxillofacial hemangiomas and vascular malformations are congenital lesions with various clinical characteristics, manifestations, indications, and possibilities for treatment. This paper reports a case of large arteriovenous malformations including a description of the features demonstrated by panoramic radiography, cone beam computed tomography, and magnetic resonance imaging. The differential diagnosis and treatment modalities (including embolization with N-butylcyanoacrylate in this case) are also discussed following the case presentation, along with the available literature review.
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13
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Collin AC, Viremouneix L, Guibaud L, Breton P. Les malformations artérioveineuses intra-osseuses. ACTA ACUST UNITED AC 2010; 111:11-8. [DOI: 10.1016/j.stomax.2009.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2009] [Accepted: 08/17/2009] [Indexed: 10/19/2022]
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Siniscalchi EN, Minutoli F, Catalfamo L, Romano F, Longo M, De Ponte FS. Intraosseous mandibular artero-venous malformations: Case report. J Craniomaxillofac Surg 2009; 37:106-9. [DOI: 10.1016/j.jcms.2008.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Revised: 10/06/2008] [Accepted: 10/09/2008] [Indexed: 11/30/2022] Open
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Granata F, De Ponte F, Pandolfo I, Pitrone A, Vinci S, Blandino A, Longo M. Arteriovenous fistula of the mandible simulating an odontogenic cyst. A case report. Interv Neuroradiol 2007; 13:385-8. [PMID: 20566108 DOI: 10.1177/159101990701300410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 11/12/2007] [Indexed: 11/16/2022] Open
Abstract
SUMMARY We describe a rare case of mandibular highflow arteriovenous malformation (AVM) mimicking an odontogenic cyst in a young man. The diagnosis of mandibular AVM was made by CT angiography and confirmed by digital subtraction angiography. CT scan showed the extent of mandibular bone alteration and a double enlarged mandibular canal on the same side. An AVM containing a large aneurysm was demonstrated by CT angiography.The mandibular AVM was successfully treated by endovascular therapy with Guglielmi detachable coils. On panoramic radiogram, mandibular AVMs can appear as cystic lesions without pathognomonic features. Several benign and malignant tumours of this anatomical region must be considered in the differential diagnosis.We emphasize the radiological sign of double enlarged mandibular canal and the diagnostic role of CT, particularly CT angiography, to discriminate a mandibular AVM from neoplastic entities of this region, sparing the risks of a needle biopsy.
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Affiliation(s)
- F Granata
- Department of Radiology - University of Messina, Italy -
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17
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Casanova D, Bardot J, Bartoli JM, Magalon G. Traitement chirurgical des malformations artérioveineuses. ANN CHIR PLAST ESTH 2006; 51:456-70. [PMID: 17007986 DOI: 10.1016/j.anplas.2006.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
MAV surgery remains still today one of most difficult in the surgery of vascular malformations. Embolisation the most selective possible follow-up of a surgical removal carrying the totality of the nidus is the only effective treatment. Usually, MAV of small size, quiescent, should not be operated, the surgery being reserved for the evolutionary or complicated forms. This surgical procedure must allow the complete eradication of the lesion without which the cure is not possible. The incomplete removal causes repetition, sometimes aggravation with, sometimes, life threatening problems.
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Affiliation(s)
- D Casanova
- Service de chirurgie plastique et réparatrice, hôpital Nord, chemin des Bourrelly, 13015 Marseille, France.
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Chen W, Wang J, Li J, Xu L. Comprehensive Treatment of Arteriovenous Malformations in the Oral and Maxillofacial Region. J Oral Maxillofac Surg 2005; 63:1484-8. [PMID: 16182916 DOI: 10.1016/j.joms.2005.04.036] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2005] [Accepted: 04/06/2005] [Indexed: 11/16/2022]
Abstract
PURPOSE Arteriovenous malformations (AVMs) in the oral and maxillofacial region are rare but potentially life-threatening vascular lesions. We report our experience in treating these lesions in the oral and maxillofacial region. PATIENTS AND METHODS Superselective intra-arterial embolization (SIAE), sclerotherapy, bone wax packing of bone cavity and curettage, radiotherapy, and surgical resection were used alone or in combination in 28 patients with AVMs in the oral and maxillofacial region. Among them there are 13 cases involving the soft tissue, 11 cases involving bone, and 4 cases involving both the soft tissue and bone. RESULTS Follow-up ranged from 3 to 60 months (median, 22 months) after comprehensive treatment. The rates of improvement and cure were 89.3% and 60.7%, respectively. Sclerotherapy in 6 cases of AVMs was ineffective. The rates of improvement and cure in AVMs involving soft tissue treated by surgical resection were 23.1% and 84.6%, respectively. The rates of cure for AVMs involving the jaws treated by SIAE, bone wax packing, curettage, and partial bone resection alone or in combination was 100%. CONCLUSION Three cases of AVMs involving both soft tissue and bone treated with SIAE and radiotherapy as well as surgical resection were cured. SIAE was an adjunctive treatment for the AVMs of soft tissue and jaws and for controlling bleeding. Surgical resection was an important treatment modality for AVMs. Bone wax packing of bone cavity and curettage was a simple, safe, and effective method for the treatment of AVMs of the jaws. Radiotherapy and sclerotherapy may not be effective methods for AVMs involving the soft tissue.
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Affiliation(s)
- Weiliang Chen
- Department of Oral and Maxillofacial Surgery, the Second Affiliated Hospital of Sun Yat-sen University, 107 Yanjiang Road, Guangzhou 510-120, China.
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Sreevathsa MR, Lalitha RM, Prasad K. Arteriovenous malformations of the head and neck: experience with magnetic resonance angiography and therapeutic embolisation. Br J Oral Maxillofac Surg 2003; 41:75-7. [PMID: 12694697 DOI: 10.1016/s0266-4356(03)00027-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- M R Sreevathsa
- Department of Oral and Maxillofacial Surgery, M.S. Ramaiah Medical College and Hospital, Bangalore, India
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