Treatment of oral vascular anomalies by transfixion technique

Lower Lip Hypertrophy Secondary to Port-Wine Stain: Combined Surgical and Carbon Dioxide Laser Treatment

BACKGROUND

Port-wine stains (PWSs) are capillary malformations that usually show progressive stasis of the vascular channels and cause slow hyperplasia of the soft and hard tissues. When these lesions involve the lower lip, macrocheilia may be developed along the time. Vascular-specific lasers are not adequate to correct these three-dimensional tissue deformities, and surgical management becomes necessary, resulting in considerable morbidity and aesthetic disturbances.

OBJECTIVE

To report a case of macrocheilia secondary to PWS treated by combination of surgery and carbon dioxide laser.

METHODS

A 51-year-old man with macrocheilia of the lower lip and severe functional impairment, secondary to long evolution PWS, received treatment with carbon dioxide laser vaporization and minimal surgical correction, resulting in significant improvement of the lower lip hypertrophy, good aesthetic and functional status, and preservation of the muscular function.

CONCLUSIONS

Combined carbon dioxide laser and surgery treatment may constitute a valuable alternative in treatment of macrocheilia secondary to PWS because bleeding risk is minimized and improves the preservation of muscular function and aesthetic results in relationship to conventional surgical approaches.

Blood flow in and around the masseter muscle: normal and pathologic features demonstrated by color Doppler sonography

OBJECTIVE

The purpose of this study was to clarify the normal findings of arteries in and around the masseter muscle and to present their pathologic changes with the use of color Doppler sonography.

STUDY DESIGN

The vascular appearances were examined for the 4 main arteries feeding the masseter muscle in healthy volunteers (n = 38) and patients with inflammation (n = 5) and intramuscular hemangioma (n = 3). The features of these arteries were investigated together with the flow diameter, flow velocities, and arterial resistances. The symmetry indices were also calculated to assess the pathologic changes.

RESULTS

The detection rates of the branch from the transverse facial artery, the masseter artery, and the branch from the maxillary or external carotid artery were 98.7%, 21.1%, and 84.2% in healthy volunteers, respectively. The facial artery that feeds the muscle from the inferior part represented 2 patterns according to anatomic variant: the masseteric branch (22.4%) and the main trunk itself (77.6%). The means of the flow diameter, maximum and minimum velocities, resistive index, and pulsatility index in healthy subjects were 1.8 mm, 24.6 cm/s, 5.1 cm/s, 0.80, and 2.51, respectively. In most of the patients with symptoms, the symmetry indices of all measurement values increased in comparison with those of healthy volunteers.

CONCLUSION

Color Doppler sonography is useful in describing the arteries in and around the masseter muscle and has the potential of being used to depict the pathologic changes.