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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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2
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Phillips AL, Allen MA, Mukit FA, Bone TM, Noguera CM, Fowler BT, Gleysteen JP. Intraosseous Hemangioma of the Zygomatic Bone with Multidisciplinary Approach to Surgical Resection and Orbital Reconstruction. EPLASTY 2024; 24:e27. [PMID: 38846502 PMCID: PMC11155339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background Intraosseous hemangiomas are rare benign tumors comprising fewer than 1% of all osseous tumors; even more uncommon are intraosseous hemangiomas of the zygomatic bone. This case reports a multidisciplinary approach for excision and reconstruction of an intraosseous hemangioma of the zygomatic bone in a 54-year-old female. Methods Multidisciplinary approach with both otolaryngology head and neck surgery and oculofacial plastics and reconstructive surgery included right lateral canthotomy and right transconjunctival orbitotomy with en-bloc excision of the zygomatic arch, followed by reconstruction of the orbital rim, orbital floor, and eyelid with Medpor implant. Results Final surgical pathology was consistent with intraosseous hemangioma of the zygomatic bone. At 4-month follow-up, the patient was healing well with good midface projection and without any visual deficits. Conclusions A multidisciplinary coordinated case allowed us to meet the standard of maintaining cosmesis and function while undergoing resection of a rare tumor involving a key facial structure-the zygoma. Involvement of oculofacial plastics and reconstructive surgery service allowed for advanced eyelid reconstruction techniques to limit any functional impairment to our patient with deliberate choice of implant material for well-adhered, durable, and aesthetically optimal reconstruction of the right malar eminence, lateral orbital rim, and orbital floor defect. The postoperative result through the multidisciplinary approach was a near symmetrical facial reconstruction without any associated eyelid or globe abnormalities.
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Affiliation(s)
- Alisa L. Phillips
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
| | - Meredith A. Allen
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
| | - Fabliha A. Mukit
- Department of Oculofacial Plastics and Reconstructive Surgery, University of Tennessee Health Science Center College of Medicine, Hamilton Eye Institute, Memphis, Tennessee
| | - Tyler M. Bone
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
| | - Cynthia M. Noguera
- Department of Oculofacial Plastics and Reconstructive Surgery, University of Tennessee Health Science Center College of Medicine, Hamilton Eye Institute, Memphis, Tennessee
| | - Brian T. Fowler
- Department of Oculofacial Plastics and Reconstructive Surgery, University of Tennessee Health Science Center College of Medicine, Hamilton Eye Institute, Memphis, Tennessee
| | - John P. Gleysteen
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
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3
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Cerqueira É, Correia S, Ramalhosa F, Lopes T, Mendes Abreu J. Challenges and Management of Capillary Intraosseous Hemangioma in the Mandibular Symphysis: A Case Report. Cureus 2024; 16:e58035. [PMID: 38738024 PMCID: PMC11088288 DOI: 10.7759/cureus.58035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
Capillary intraosseous hemangioma is a benign vascular neoplasm that affects bone tissue, yet its occurrence in the jaw bones has been seldom reported in the literature. We present a case of a capillary intraosseous hemangioma located in the mandibular symphysis of a 28-year-old male. Initially addressed by the patient's dentist as an infectious lesion of endodontic origin, the sudden worsening of the condition, marked by the development of a rapidly expanding exophytic mandibular lesion and tooth mobility, led to the consideration of various potential diagnoses. Subsequently, an incisional biopsy was performed, triggering multiple episodes of recurrent bleeding, leading to several visits to the emergency department, and prompting an urgent status upgrade for the patient. Upon the histological diagnosis of vascular neoplasm, the patient underwent the excision of the lesion, with a favorable and uneventful evolution, although with expected sequelae. As a result, a temporary prosthetic solution, comprising a Maryland Bridge, was implemented, with plans for guided bone regeneration and implant-supported fixed dental prostheses currently in progress. This case underscores the diagnostic and therapeutic challenges associated with this rare condition. Consequently, achieving the optimal outcome for the patient largely depends on a multidisciplinary approach, emphasizing the critical importance of thorough preoperative assessment, along with a well-devised treatment plan and rapid intervention.
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Affiliation(s)
| | | | - Fátima Ramalhosa
- Pathology, Clinical and Academic Centre of Coimbra, Coimbra, PRT
| | - Teresa Lopes
- Maxillofacial Surgery, ULS Coimbra, Coimbra, PRT
| | - João Mendes Abreu
- Faculty of Medicine, Clinical and Academic Centre of Coimbra, Coimbra, PRT
- Stomatology, Clinical and Academic Centre of Coimbra, Coimbra, PRT
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Masoomian B, Asadigandomani H, Rafizadeh SM, Ghodous S, Nozarian Z. Orbital primary intraosseous hemangioma in a three-month old infant: A case report. Am J Ophthalmol Case Rep 2024; 33:101982. [PMID: 38230391 PMCID: PMC10789994 DOI: 10.1016/j.ajoc.2023.101982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/21/2023] [Accepted: 12/20/2023] [Indexed: 01/18/2024] Open
Abstract
Purpose To report a 3-month-old boy with rapid progressive orbital intraosseous hemangioma which was treated with excisional biopsy and orbital rim reconstruction. Observation A 3-month-old boy was referred with the aggressive growth of a mass on the right orbital region. The mass was noted to develop over 4 weeks. On presentation this firm nontender orbital mass measuring 5 × 5cm mimicked a more ominous malignancy. The spiral computed tomography scan showed a destructive mass with protrusion superiorly and inferiorly toward the orbital cavity and anterior cranial fossa. The patient underwent gross tumor resection and reconstruction of the orbital rim. Histology findings revealed an intraosseous hemangioma. There was no evidence of recurrence after 1-year follow-up. Conclusion and Importance Due to rapid progression, the patient's age, and lesion size, this case is unique. There were additional challenges regarding complete resection, intra-cranial extension, and significant blood loss in an infant. Therefore, in the face of rapidly progressing orbital tumors in infants, despite the very low prevalence of intraosseous hemangioma, this diagnosis should be considered.
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Affiliation(s)
- Babak Masoomian
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Asadigandomani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Rafizadeh
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Ghodous
- Department of Medical Sciences, Guilan University of Medical Sciences, Rasht, Iran
| | - Zohreh Nozarian
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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5
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Londhe MM, Patil TV, Akhare SR. Intraosseous Hemangioma of Zygoma: A Case Report with Review of Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:4024-4027. [PMID: 37974668 PMCID: PMC10646063 DOI: 10.1007/s12070-023-03982-0] [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: 05/10/2023] [Accepted: 06/13/2023] [Indexed: 11/19/2023] Open
Abstract
Intraosseous hemangiomas are uncommon and account to less than 1% of all osseous tumors. Vertebral body and skull are the most common sites involved. However involvement of facial bones is rare with zygoma being even rarer site. Due to its rarity it creates diagnostic dilemma clinically and radiologically. Its vascular nature carries the risk of intraoperative bleeding hence an accurate preoperative diagnosis with arterial embolization helps to avoid the dire consequences. Fine needle aspiration cytology along with radiological correlation is extremely helpful in such cases. We report such rare case in forty eight years female patient with brief review of literature.
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Affiliation(s)
- Mangesh M. Londhe
- Department of Pathology, PCMCs PGI YCMH, Pimpri, Pune, 411044 India
- Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Tushar V. Patil
- Department of Pathology, PCMCs PGI YCMH, Pimpri, Pune, 411044 India
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Dogan E, Kulekci C, Ozer S. Endoscopic Excision of the Intraosseous Hemangioma of the Nasal Bone. Indian J Otolaryngol Head Neck Surg 2023; 75:2387-2389. [PMID: 37636700 PMCID: PMC10447760 DOI: 10.1007/s12070-023-03729-x] [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: 01/28/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023] Open
Abstract
An intraosseous hemangioma is a rare benign tumor of the bone. Moreover, it is rarely observed in the nasal bone. A 58-year-old female patient complained of swelling in the nasal dorsum and mild pain. CT showed a round mass with a honeycomb appearance meanwhile, MRI revealed a hypointense mass in T1 sequences and hyperintense in T2 and gadolinium sequences. Endoscopic removal of the intraosseous hemangioma was performed. No recurrence was observed in the post-op 6th-month follow-up. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03729-x.
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Affiliation(s)
- Enes Dogan
- Department of Otorhinolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, 06100 Turkey
| | - Cagri Kulekci
- Department of Otorhinolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, 06100 Turkey
| | - Serdar Ozer
- Department of Otorhinolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, 06100 Turkey
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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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8
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Ye Z, Li C, Liu Y, You M. Intraosseous venous malformation of the zygoma: Case report and pooled analysis. J Craniomaxillofac Surg 2023; 51:490-496. [PMID: 37574385 DOI: 10.1016/j.jcms.2023.07.001] [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: 02/20/2023] [Revised: 05/29/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023] Open
Abstract
The objective of this study is to provide a comprehensive summary of the clinical and radiological features of zygomatic intraosseous venous malformations (IVM), as well as its treatment strategies. The aim is to establish preoperative diagnostic bases that will aid in the identification of zygomatic IVM and facilitate the implementation of effective treatment. Four cases of pathologically diagnosed zygomatic IVM with typical clinical and radiological features were reported. They exhibited comparable clinical and radiological features, and the En bloc excision and reconstruction yielded satisfactory outcome. Pooled data analysis was performed with additional 74 cases collected from 63 previous studies. The results revealed a higher incidence of zygomatic IVMs in middle-aged females, with swelling, pain and ocular dysfunction being the typical clinical manifestations. The characteristic radiological features of these lesions were well-defined, round bony structures with specific internal trabecular patterns. A diagnostic flow-chart assisting the differential diagnosis of IVM was established. En bloc excision was deemed the most advantageous treatment option, as it presented minimal risk of haemorrhaging and no instances of recurrence. The decision to pursue reconstruction was contingent upon the extent of the defect. Alloplastic material has emerged as the most frequently employed reconstruction material in recent reports. The summarized characteristics of zygomatic IVM and the proposed diagnostic and treatment strategies, derived from the pooled analysis of reported cases, may help to improve diagnosis and management in further clinical practice.
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Affiliation(s)
- Zelin Ye
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Chenyang Li
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - YuanYuan Liu
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Meng You
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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9
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Dean A, Heredero‐Jung S, Solivera J, Sanjuan A, Alamillos‐Granados FJ. Computer-assisted and navigated piezoelectric surgery: A new technology to improve precision and surgical safety in craniomaxillofacial surgery. Laryngoscope Investig Otolaryngol 2022; 7:684-691. [PMID: 35734050 PMCID: PMC9195016 DOI: 10.1002/lio2.786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/05/2022] [Accepted: 03/14/2022] [Indexed: 11/12/2022] Open
Abstract
Background Computer-assisted navigated piezoelectric surgery (CANPS) is a surgical technique that combines the surgical navigation with a piezoelectric device. This association multiplies the advantages of both technologies, taking the best of each one providing a synergistic association. Objective To describe and assess the indications, advantages, disadvantages, and complications of this association of surgical techniques. Methods CANPS was used in 32 patients. The clinical diagnosis was facial trauma, tumors, orthognathic surgeries, temporomandibular joint ankylosis, pathology of the frontal sinus, and alveolar distraction. Nineteen patients were men and 13 were women. Planning software iPlan 3.05 of Brainlab, and Elements of Brainlab were used for planning and the Kolibri and Kurve of Brainlab for surgical navigation. The piezoelectric device used was a "Vercelotti" type in all patients. Results CAPNS could be performed successfully in all cases without complications and reduced the surgeon's uncertainty during the osteotomies. There is continuous control of the position of the surgical instrument. The use of the navigated piezoelectric device allowed the surgeon's uncertainty to be reduced during the performance of the osteotomies in depth, in poorly visible areas, with little access or reduced visibility. It also increases the safety of bone resections near important anatomical structures. Conclusions CANPS combines the advantages of piezoelectric surgery and navigation. CANPS affords real-time control of the position of the cutting tip and allows semiburied approaches. CANPS allows surgery to be precise, safer, and minimally invasive.
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Affiliation(s)
- Alicia Dean
- Department of Oral and Maxillofacial SurgeryReina Sofía University HospitalCórdobaSpain
| | - Susana Heredero‐Jung
- Department of Oral and Maxillofacial SurgeryReina Sofía University HospitalCórdobaSpain
| | - Juan Solivera
- Department of Oral and Maxillofacial SurgeryReina Sofía University HospitalCórdobaSpain
- Department of NeurosurgeryReina Sofía University HospitalCórdobaSpain
| | - Alba Sanjuan
- Head and Neck Oncology/Microvascular SurgeryAscension‐St John HospitalDetroitUSA
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Monroy D, Garcia J, Zarate SD, Belzarena AC. Displaced humeral pathological fracture secondary to intraosseous hemangioma. Radiol Case Rep 2022; 17:1609-1613. [PMID: 35313567 PMCID: PMC8933724 DOI: 10.1016/j.radcr.2022.02.020] [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: 01/29/2022] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 10/30/2022] Open
Abstract
Intraosseous hemangiomas are uncommon slow-growing benign bone tumors. Most of these lesions are located in the spine or skull and long bone location is rare. Here we present the case of a 63-year-old female with a pathological fracture of the left proximal humerus through an intraosseous hemangioma. Imaging features can be highly unspecific when these tumors are found in the long bones. In this case a pathological fracture obscured the diagnosis even further, prompting the need for tissue sampling to exclude an underlying malignancy.
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11
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Ingle M, Sarode SC, Ingle Y, Sarode GS, Yuwanati M. Embolization assisted surgical excision of primary intra-osseous hemangioma of the zygomatic bone. Oral Oncol 2021; 123:105632. [PMID: 34823158 DOI: 10.1016/j.oraloncology.2021.105632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 11/14/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Manjusha Ingle
- Department of Oral Medicine and Radiology, M A Rangoonwala College of Dental Science & Research Centre, Pune, India
| | - Sachin C Sarode
- Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra State, Pune, India
| | - Yashwant Ingle
- Department of Dentistry, Yashwantrao Chavan Memorial Hospital, Sant-Tukaram Nagar, Pimpri, Pune 411018, India
| | - Gargi S Sarode
- Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra State, Pune, India
| | - Monal Yuwanati
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India.
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Antúnez-Conde R, Navarro Cuéllar C, Salmerón Escobar JI, Díez-Montiel A, Navarro Cuéllar I, Dell’Aversana Orabona G, del Castillo Pardo de Vera JL, Navarro Vila C, Cebrián Carretero JL. Intraosseous Venous Malformation of the Zygomatic Bone: Comparison between Virtual Surgical Planning and Standard Surgery with Review of the Literature. J Clin Med 2021; 10:jcm10194565. [PMID: 34640581 PMCID: PMC8509390 DOI: 10.3390/jcm10194565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 01/02/2023] Open
Abstract
Intraosseous venous malformations affecting the zygomatic bone are infrequent. Primary reconstruction is usually accomplished with calvarial grafts, although the use of virtual surgical planning, cutting guides and patient-specific implants (PSI) have had a major development in recent years. A retrospective study was designed and implemented in patients diagnosed with intraosseous venous malformation during 2006–2021, and a review of the scientific literature was also performed to clarify diagnostic terms. Eight patients were treated, differentiating two groups according to the technique: four patients were treated through standard surgery with resection and primary reconstruction of the defect with calvarial graft, and four patients underwent resection and primary reconstruction through virtual surgical planning (VSP), cutting guides, STL models developed with CAD-CAM technology and PSI (titanium or Polyether-ether-ketone). In the group treated with standard surgery, 75% of the patients developed sequelae or morbidity associated with this technique. The operation time ranged from 175 min to 210 min (average 188.7 min), the length of hospital ranged from 4 days to 6 days (average 4.75 days) and the postoperative CT scan showed a defect surface coverage of 79.75%. The aesthetic results were “excellent” in 25% of the patients, “good” in 50% and “poor” in 25%. In the VSP group, 25% presented sequelae associated with surgical treatment. The operation time ranged from 99 min to 143 min (average 121 min), the length of hospital stay ranged from 1 to 2 days (average of 1.75 days) and 75% of the patients reported “excellent” results. Postoperative CT scan showed 100% coverage of the defect surface in the VSP group. The multi-stage implementation of virtual surgical planning with cutting guides, STL models and patient-specific implants increases the reconstructive accuracy in the treatment of patients diagnosed with intraosseous venous malformation of the zygomatic bone, reducing sequelae, operation time and average hospital stay, providing a better cover of the defect, and improving the precision of the reconstruction and the aesthetic results compared to standard technique.
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Affiliation(s)
- Raúl Antúnez-Conde
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Carlos Navarro Cuéllar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
- Correspondence:
| | - José Ignacio Salmerón Escobar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Alberto Díez-Montiel
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Ignacio Navarro Cuéllar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | | | | | - Carlos Navarro Vila
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - José Luis Cebrián Carretero
- Maxilofacial Surgery Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.L.d.C.P.d.V.); (J.L.C.C.)
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Intraosseous Venous Malformation of the Zygomatic Bone: Virtual Surgical Planning and Reconstruction With Customized CAD-CAM Titanium Implant. J Craniofac Surg 2021; 32:e757-e759. [PMID: 34191769 DOI: 10.1097/scs.0000000000007751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT Zygomatic intraosseous vascular anomalies are uncommon. Most cases have been reported without a precise diagnosis. The prevalence is 3:1 women during the fourth decade of life. The study of these lesions includes clinical findings, radiological studies, such as computed tomography and magnetic resonance imaging scans, and a postoperative histological study of the specimen. Biopsy is not recommended because of the risk of bleeding. Complete surgical resection remains the gold standard elective treatment.The case of a patient with an intraosseous venous malformation of the zygomatic bone is presented, detailing the clinical, histological, and radiological characteristics and the surgical treatment with a primary reconstruction through Computer-Aided Design/Computer-Aided Manufacturing customized titanium implant guided by virtual surgical planning with a reduction of surgical time and morbidity in the donor area with optimal functional and aesthetic results.
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14
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Use of an Ultrasonic Aspirator in Removal of an Orbital Rim Hemangioma. Ophthalmic Plast Reconstr Surg 2021; 37:e117-e120. [PMID: 33481536 DOI: 10.1097/iop.0000000000001886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Intraosseous hemangiomas are rare bony neoplasms that infrequently develop in the calvarium or facial bones. Due to their highly vascular nature, biopsy or resection of these tumors can present a surgical challenge, with reports of significant blood loss during tumor resection. Traditional surgical resection of intraosseous hemangiomas often includes the use of high speed oscillating or sagittal saws. Ultrasonic aspirators, which spare adjacent soft-tissue structures and minimize blood loss, have been successfully used in resection of firm soft tissue masses of the orbit; however, this technology has not been demonstrated in the treatment of a vascular tumor in the orbit. The authors present the case of a 37-year-old woman who presented with an intraosseous hemangioma at the left inferior orbital rim and maxilla; the mass was successfully resected with the aid of a Sonopet Ultrasonic Aspirator bone knife. The knife allowed for simultaneous emulsification and cautery of the bone encasing the mass with low risk to sensitive surrounding tissue.
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15
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Kim YW, Kim ST, An J, Kang M, Chi M. Successful Treatment of Dacryocystocele due to Secondary Nasolacrimal Duct Obstruction by Intraosseous Cavernous Hemangioma. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.2.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Intraosseous Hemangioma of Nasal Bone: Unusual Cause of Epiphora. J Craniofac Surg 2021; 31:e722-e723. [PMID: 32604276 DOI: 10.1097/scs.0000000000006710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Intraosseous hemangioma is very rare, accounting for <1% of bone tumors. Nasal bone origin of it is even rarer. A 63-year-old female patient visited our clinic with a complaint of epiphora. On physical examination, about 2-cm-sized nontender and fixed mass was palpated along the left nasomaxillary suture area. Preoperative magnetic resonance imaging findings were consistent with intraosseous hemangioma originating from the nasal bone. Epiphora was thought to be developed due to the mass effect and a marginal resection of the mass was performed. The defect was reconstructed with a septal cartilage and porous polyethylene implant (Synpor). Postoperatively, epiphora subsided and there has been no sign of recurrence or facial deformity during 6 months of follow-up.
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Liberale C, Rozell-Shannon L, Moneghini L, Nocini R, Tombris S, Colletti G. Stop Calling Me Cavernous Hemangioma! A Literature Review on Misdiagnosed Bony Vascular Anomalies. J INVEST SURG 2020; 35:141-150. [DOI: 10.1080/08941939.2020.1824041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | | | | | - Riccardo Nocini
- Department of Otorhinolaryngology, University Hospital of Verona, Verona, Italy
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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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Mandibular Fracture as First Sign of an Occult Intraosseous Hemangioma. J Craniofac Surg 2019; 30:e681-e683. [PMID: 31449226 DOI: 10.1097/scs.0000000000005863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Intraosseous hemangioma (IH) in the maxillofacial area is a very uncommon neoplasm. Here, the authors show an exceptional case not previously reported in the literature of a 65-year-old man who presented with a pathological mandibular fracture following a facial trauma that was the first sign of an occult cavernous IH. Complete excision of the tumor in the mandibular ramus reduced the risk of severe bleeding and prevented long-term recurrence, whereas immobilization of the fracture obtained an excellent functional result. This clinical report highlights the possibility that a previously unknown primary IH may debut as a pathological fracture and the importance of differential diagnosis in this location.
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Osteofascial Radial Forearm Free Flap Reconstruction of Midface Defect After Resection of Intraosseous Hemangioma. J Craniofac Surg 2018; 29:754-756. [PMID: 29485562 DOI: 10.1097/scs.0000000000004383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Intraosseous hemangiomas of the midface are rare with few reported cases in the literature. Various reconstructive methods have been previously described, but none using vascularized bone graft secondary to the benign nature of the tumor and often relatively limited defect size. CLINICAL REPORT The authors present the case of a 47-year-old man with a biopsy proven enlarging right maxillary intraosseous cavernous hemangioma which was resected primarily, resulting in a large defect involving the entire zygomaticomaxillary buttress and a portion of the right orbital floor and malar prominence. Given the structural involvement and the significant bony defect size, this was simultaneously reconstructed using an osteofascial radial forearm free flap and orbital floor titanium implant with satisfactory outcome.
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