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Heimlich FV, de Arruda JAA, Kato CDNADO, Silva LVDO, Souza LN, Ferreira MVL, Pinheiro JDJV, Silva TA, Abreu LG, Mesquita RA. Experience with 808-nm diode laser in the treatment of 47 cases of oral vascular anomalies. Braz Oral Res 2024; 38:e025. [PMID: 38597545 DOI: 10.1590/1807-3107bor-2024.vol38.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/20/2023] [Indexed: 04/11/2024] Open
Abstract
Treatment of oral vascular anomalies (OVA) has focused on minimally invasive techniques rather than radical surgery. We investigated the efficacy and safety of diode laser using the photocoagulation technique in the management of OVA. Forty-seven subjects with OVA were treated with forced dehydration with induced photocoagulation (FDIP) using diode laser (808 nm/4.5 W). This series consisted mostly of male (63.8%) and non-white (63.8%) patients with a mean age of 57.4 years. Varices (91.5%), venous malformations (6.4%), and hemangiomas (2.1%) with a mean size of 7.1 (±4.9) mm were the conditions treated. OVA presented as a nodular lesion (63.8%) involving mainly the lower lip (46.8%). Pulsed laser mode was used as standard and the number of applications varied from one to four sessions, with the majority requiring only one (83%) FDIP session. Kaplan-Meier analysis revealed that complete clinical healing can occur on the 15th day (n=9/29.5%), followed by the 20th (n=6/45.5%), and 30th (n=7/70.5%) days. Postoperative edema was observed in 31 (66%) patients, and recurrence of the lesion occurred in two (4.2%). Based on the data on complete clinical healing, minimal patient discomfort, and satisfactory esthetic results, we can confirm that FDIP by diode laser is a promising candidate for the safe and efficacious treatment of OVA.
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Affiliation(s)
- Fernanda Vieira Heimlich
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila de Nazaré Alves de Oliveira Kato
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leni Verônica de Oliveira Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leandro Napier Souza
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcus Vinicius Lucas Ferreira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Dabas SK, Menon NN, Ranjan R, Shukla H, Gurung B, Tiwari S, Bassan BB, Sinha A, Fernandes TB, Arora S, Verma A, Sharma A, Biswas S, Patnaik N, Tyagi T, Singal R. Transoral Robotic Surgery for a Rare Case of Venolymphatic Malformation in Parapharyngeal Space. Indian J Otolaryngol Head Neck Surg 2024; 76:2035-2041. [PMID: 38566704 PMCID: PMC10982192 DOI: 10.1007/s12070-023-04390-0] [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: 06/21/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
Venous malformations are low flow endothelial malformations with aberrant and ectatic venous channels. They are defects in vascular growth which causes functional and cosmetic impairment. Gradual growth in size of the lesion occurs due to venous congestion or thrombosis. Venous malformations in parapharyngeal space are a rare entity and are difficult to diagnose. Case Report. 13 year old boy presented with a history of hyposmia and progressive difficulty in breathing for a duration of 2.5 years. MRI face and neck with contrast showed a 4.5 × 4.3x3.6 cm lesion in the left parapharyngeal space. CT angiogram of brain and neck demonstrated a heterogeneously enhancing mass in the left parapharyngeal region. PET scan illustrated an ill-defined mass in the left pre styloid parapharyngeal space. Biopsy from the lesion showed features consistent with venolymphatic malformation. Flexible laryngoscopy showed a bulge over the left soft palate region with narrowing of nasopharyngeal lumen. Patient underwent transoral robotic surgery for complete excision of the mass. Post-operative period was uneventful. He has been on follow up for the past 1 year with no evidence of any residual or recurrent disease. Venolymphatic malformation is a rare lesion in the parapharyngeal space which is difficult to diagnose pre operatively. Surgical excision is the preferred modality of treatment for deep seated lesions in the parapharyngeal space. The advent of transoral robotic surgery have reduced the morbidity and improved clearance for such cases.
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Affiliation(s)
- Surendra K. Dabas
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Nandini N. Menon
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Reetesh Ranjan
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Himanshu Shukla
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Bikas Gurung
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Sukirti Tiwari
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Bharat Bhushan Bassan
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Ajit Sinha
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Trishala Bhadauria Fernandes
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Saurabh Arora
- Department of Nuclear Medicine, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Ankur Verma
- Department of Oncoanaesthesia, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Ashwani Sharma
- Department of Surgical Oncology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Shubhashish Biswas
- Department of Oncoanaesthesia, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Nivedita Patnaik
- Department of Histopathology, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Tarun Tyagi
- Department of Oncoanaesthesia, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
| | - Rishu Singal
- Department of Radiodiagnosis, BLK-MAX Super Specialty Hospital, Pusa Road, Rajendra Place, New Delhi, 110005 India
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Perkov S, Vorobev V, Kurochkin MA, Gorodkov S, Gorin D. Rapid low-cost hyperspectral imaging system for quantitative assessment of infantile hemangioma. JOURNAL OF BIOPHOTONICS 2024; 17:e202300375. [PMID: 38009761 DOI: 10.1002/jbio.202300375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023]
Abstract
Hemangioma, the predominant benign tumor occurring in infancy, exhibits a wide range of prognoses and associated outcomes. The accurate determination of prognosis through noninvasive imaging modalities holds essential importance in enabling effective personalized treatment strategies and minimizing unnecessary surgical interventions for individual patients. The present study focuses on advancing the personalized prognosis of hemangioma by leveraging noninvasive optical sensing technologies by the development of a novel rapid hyperspectral sensor (image collection in 5 s, lateral resolution of 10 μm) that is capable of quantifying hemoglobin oxygenation and vascularization dynamics during the course of tumor evolution. We have developed a quantitative parameter for hemangioma assessment, that demonstrated agreement with the clinician's conclusion in 90% among all cases during clinical studies on six patients, who visited clinician from two to four times. The presented methodology has potential to be implemented as a supportive tool for accurate hemangioma diagnostics in clinics.
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Affiliation(s)
- Sergei Perkov
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Viktor Vorobev
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Maxim A Kurochkin
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Sergey Gorodkov
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
- Faculty of Pediatrics, Saratov State Medical University, Saratov, Russia
| | - Dmitry Gorin
- Center for Photonic Science and Engineering, Skolkovo Institute of Science and Technology, Moscow, Russia
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de Souto Medeiros MR, da Silva Barros CC, Rolim LSA, Pinto LP, Miguel MCDC, da Silveira ÉJD. Hamartomas, choristomas, and teratomas of the oral cavity: A 49-years cross-sectional study in an oral diagnostic service. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101765. [PMID: 38218332 DOI: 10.1016/j.jormas.2024.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/06/2023] [Accepted: 01/10/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND To investigate the incidence and demographic profile of hamartomatous, choristomatous, and teratoid lesions in a Brazilian population over a 49 years-period. METHODS A retrospective cross-sectional study was performed, and data regarding demographic and clinical aspects were obtained from the medical records of a [removed for blind peer review] referral center (1970-2019). The collected data were submitted to descriptive analysis and Pearson's chi-square, Fisher's exact, and Kruskal-Wallis tests (p ≤ 0.05). RESULTS In a total of 16,412 medical records analyzed, 300 (1.83 %) were hamartomatous, 2 (0.01 %) choristomatous, and 1 (0.01 %) teratoid lesions. Hamartomas were most diagnosed in females and adults. Statistical significance was observed between hamartoma and age group (p < 0.001). Odontoma was the most frequent hamartomatous lesion. In choristomatous and teratoid lesions, there was no occurrence in males. The jaws were the most affected anatomical site by hamartoma. Choristomas were observed on the mandible and tongue, while a teratoid lesion was seen on the floor of the mouth. CONCLUSIONS Low occurrence of choristomatous and teratoid lesions over hamartomatous lesions and a heterogeneous occurrence profile regarding sex, age group, and anatomic site were observed. Hamartomas are relatively common and benign conditions that may cause damage and require special care during dental treatment. Thus, the dentist needs to be able to identify and treat them appropriately. Likewise, although choristomas and teratomas present no risk to patients and have a lower occurrence than hamartomas, they also require treatment.
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Affiliation(s)
- Maurília Raquel de Souto Medeiros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Caio César da Silva Barros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Larissa Santos Amaral Rolim
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Leão Pereira Pinto
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Márcia Cristina da Costa Miguel
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Éricka Janine Dantas da Silveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil.
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Hankinson P, Brierley C, Brierley D. A review of oral pathology in orthodontics. Part 1: Soft-tissue pathology. Am J Orthod Dentofacial Orthop 2024; 165:7-17. [PMID: 37930299 DOI: 10.1016/j.ajodo.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 11/07/2023]
Abstract
Orthodontists are well placed to detect soft-tissue disease of the oral cavity and associated structures because of the frequent repeat examinations of their patients. This review describes the clinical manifestations, pathologic features, and treatment of the soft-tissue pathology most likely to be encountered by the orthodontist and uncommon soft-tissue disease with significant implications for the patient. The recognition of soft-tissue disease will allow reassurance, referral, and early intervention when required.
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Affiliation(s)
- Paul Hankinson
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.
| | - Catherine Brierley
- Orthodontic Department, Charles Clifford Dental Hospital, Sheffield, United Kingdom; Chesterfield Royal Hospital, Calow, Chesterfield, United Kingdom
| | - Daniel Brierley
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
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Kerr AM, Lin S, Sisk BA. Mental and physical health of adult patients affected by complex vascular anomalies. PATIENT EDUCATION AND COUNSELING 2023; 117:107987. [PMID: 37769517 DOI: 10.1016/j.pec.2023.107987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/14/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE We examined care and communication factors that affect physical and mental health for patients with complex vascular anomalies (VAs). METHODS VA patients (N = 135) completed an online survey with measures of ability to navigate healthcare, quality of information exchange, perceived stigma, and demographic variables. We performed linear regression to determine if these variables were associated with mental and physical health. RESULTS Physical and mental health were associated with information exchange (β = .41, 95% CI=.12 -.69; β = .33, 95% CI=.04 -.62), stigma (β = -.49, 95% CI=-.74 to -.24; β = -.63, 95% CI=-.89 to -.38), and education (β = 4.00, 95% CI=.63 - 7.38; β = 3.44, 95% CI=.06 to 6.82). Ability to navigate healthcare was associated with health outcomes in our bivariate model, but not significant in a multivariate model. CONCLUSION The results underscore the importance of effective information exchange. Poor information exchange was associated with worse physical and mental health. VA patients with lower education levels and higher perceived stigma reported poorer health outcomes and likely face many struggles accessing care. PRACTICE IMPLICATIONS Patient-centered information exchange between clinicians and patients is needed to address unmet information needs. Clinicians can also reduce perceived stigma by validating patients, and should provide resources to reduce disparities related to education.
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Affiliation(s)
- Anna M Kerr
- Department of Primary Care, Ohio University, Dublin, OH, USA.
| | - Sunny Lin
- Informatics Institute, Department of Medicine, Washington University, St. Louis, MO, USA
| | - Bryan A Sisk
- Division of Hematology/Oncology, Washington University, St. Louis, MO, USA; Bioethics Research Center, Washington University, St. Louis, MO, USA
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7
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Fuad M, Goh BS, Lokman FL, Mohamad Yunus MR. Blue Parotid Unveiled: A Rare Case of Traumatic Hemorrhagic Parotid Lymphangioma in an Eight-Year-Old Boy. Cureus 2023; 15:e46415. [PMID: 37927667 PMCID: PMC10621628 DOI: 10.7759/cureus.46415] [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: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Parotid lymphangioma is a benign lymphatic malformation commonly observed in infancy or early childhood. It often grows insidiously and presents as a painless, soft fluctuant mass. We report a case of an eight-year-old boy who was diagnosed from another center with right parotid lymphangioma of one-year duration. He presented with right painful preauricular swelling and trismus for nine days after a recent history of blunt trauma to the preauricular caused an acute expansion of the swelling and subsequently, the patient developed ipsilateral facial nerve palsy. Examination showed right preauricular swelling measuring about 6 x 6 cm that extended posteriorly until the mastoid region, superiorly until the zygoma, and inferiorly until the angle of the mandible, pushing the ear lobule anteromedially. There was bluish discoloration of the overlying skin. The swelling was warm and tender on palpation. Multiple shotty lymph nodes were palpable at the posterior triangle. Aspiration of the swelling revealed blood content, but it reaccumulated after a few hours. A magnetic resonance imaging (MRI) of the neck showed a lesion confined within the parotid gland. There was a presence of air-fluid level with dependent layers of hyperintense on the T1-weighted image (T1WI) and T2-weighted image (T2WI) with clumps of isointensity on T1WI, which are hypointense on T2WI, which is suggestive of acute-late subacute blood product. A diagnosis of lymphatic malformation complicated with hemorrhage was made. Hence, the patient underwent surgery for the evacuation of blood clot and right superficial parotidectomy. Histopathological examination of the intraoperative tissue biopsy revealed evidence of venolymphatic malformation of the parotid gland. Postoperatively, he was discharged home after three days. The facial nerve function recovered from House and Brackmann grade II to grade I three weeks after the surgery.
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Affiliation(s)
- Muizzuddin Fuad
- Otolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Bee See Goh
- Otorhinolaryngology/Pediatrics Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Farah Liana Lokman
- Otolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Mohd Razif Mohamad Yunus
- Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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8
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Ryu J, Igawa T, Mohole J, Coward M. Congenital Neck Masses. Neoreviews 2023; 24:e642-e649. [PMID: 37777610 DOI: 10.1542/neo.24-10-e642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
There are many possible causes of congenital neck masses, with the most common ones being thyroglossal duct cysts, branchial cleft anomalies, and vascular malformations. Most congenital neck masses are asymptomatic in the neonatal period, but depending on the location and the size, they can cause airway obstruction and serious complications at birth. Proper diagnosis is important for optimal treatment planning, and if the airway is compromised, multidisciplinary teamwork is critical for proper airway management. This review summarizes the clinical features, etiology, diagnosis, management, and prognosis of different types of congenital neck masses.
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Affiliation(s)
- Jane Ryu
- Department of Pediatrics/Neonatology, University of California, Los Angeles Mattel Children's Hospital, Los Angeles, CA
| | - Teryn Igawa
- Department of Pediatrics/Neonatology, University of California, Los Angeles Mattel Children's Hospital, Los Angeles, CA
| | - Jyodi Mohole
- Department of Pediatrics/Neonatology, University of California, Los Angeles Mattel Children's Hospital, Los Angeles, CA
| | - Melissa Coward
- Department of Pediatrics/Neonatology, University of California, Los Angeles Mattel Children's Hospital, Los Angeles, CA
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Lim T, Kim D, Lee HW, Ohe JY, Jung J. Usefulness of a Low-Dose Sclerosing Agent for the Treatment of Vascular Lesions in the Tongue. Cureus 2023; 15:e45323. [PMID: 37849611 PMCID: PMC10577093 DOI: 10.7759/cureus.45323] [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: 09/15/2023] [Indexed: 10/19/2023] Open
Abstract
Hemangiomas and vascular malformations are common benign lesions of vessels in the cervical region. However, the lesions may not completely disappear and may require surgical or nonsurgical intervention. Several treatment options, including surgical excision, steroid injection, laser therapy, and sclerotherapy, are available. Surgical excision is a commonly used treatment; however, in cases of hemangiomas of the tongue, excision of the lesion may cause esthetic or functional impairments, including speech and swallowing. Sclerotherapy is a simple and safe method for treating vascular lesions conservatively. In this case report, two patients with a vascular lesion of the tongue underwent conservative sclerotherapy without surgical excision using a sclerosing agent (sodium tetradecyl sulfate). Both patients showed regression of the lesion without complications. As presented in these cases, repeated injections of low-dose 1% sodium tetradecyl sulfate as a sclerosing agent were safe and showed satisfactory outcomes.
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Affiliation(s)
- Taeil Lim
- Oral and Maxillofacial Surgery, Kyung Hee University, Seoul, KOR
| | - Doogyum Kim
- Oral and Maxillofacial Surgery, Kyung Hee University, Seoul, KOR
| | - Hyun-Woo Lee
- Oral and Maxillofacial Surgery, Eulji University, Uijeongbu, KOR
| | - Joo-Young Ohe
- Oral and Maxillofacial Surgery, Kyung Hee University, Seoul, KOR
| | - Junho Jung
- Oral and Maxillofacial Surgery, Kyung Hee University, Seoul, KOR
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Menon NN, Bharathi MB. Rare Presentation of Venous Malformation in Parapharyngeal Space. Indian J Otolaryngol Head Neck Surg 2023; 75:2453-2455. [PMID: 37636612 PMCID: PMC10447762 DOI: 10.1007/s12070-023-03683-8] [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: 01/18/2022] [Accepted: 03/05/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Venous malformations are commonly seen in muscles like masseter, temporalis, tongue musculature, oral and airway mucosa in the head and neck region but is rarely seen in parapharyngeal space. Case Summary We report a case of a 60 year female patient who presented with foreign body sensation of throat, sticky sensation and dysphagia to solids for 2 years. She was subjected to relevant investigations including MRI and USG guided FNAC. Following which she underwent endoscopic parapharyngeal space tumour excision and specimen was sent for HPE. Post operatively patient is doing well and symptomatically better. She is being followed up on regular basis. Conclusion Parapharyngeal space tumours accounts for only 0.5% of head and neck tumours, of which 70 to 80% are benign and the rest are malignant. Out of the benign tumours of parapharyngeal space we should also keep in mind rare tumours like venous malformations.
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Affiliation(s)
- Nandini N Menon
- Department of Surgical oncology, BLK- MAX Super speciality hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - M B Bharathi
- ENT and Head and Neck surgery, JSS Medical college and hospital, Mysore, Karanataka India
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11
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Israrahmed A, Singh V, Prasad SN, Singh AK, Bhatnagar A, Singh A, Phadke RV. Management of scalp arteriovenous malformations: a rising trend towards percutaneous direct puncture embolization technique-our experience. Acta Radiol 2023; 64:2431-2438. [PMID: 37192645 DOI: 10.1177/02841851231174458] [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: 05/18/2023]
Abstract
BACKGROUND Scalp arteriovenous malformations (AVMs), or cirsoid aneurysms of the scalp, usually present with troublesome symptoms and cosmetic disfigurement. Endovascular/percutaneous embolization has evolved as a sole treatment method or adjunct to surgical excision in the management of scalp AVMs with an excellent outcome. PURPOSE To discuss minimally invasive techniques for treating scalp AVMs as well as to highlight the role of embolization before surgery. MATERIAL AND METHODS This is a retrospective study of 50 patients with scalp AVM who underwent embolization (percutaneous/endovascular) during 2010-2019 at a tertiary care center. n-butyl cyanoacrylate (n-BCA) was used as an embolizing agent in all the cases and the patients were followed up at three- and six-month intervals with Doppler evaluation. RESULTS A total of 50 patients were included in the study. The occipital region was the most common location; 82% were Schobinger class II lesions and 18% were class III lesions. Thirteen patients had small-sized AVMs and 37 patients had large-sized AVMs. Post-embolization surgery was performed in 36 patients. Of the patients, 28 underwent percutaneous embolization, 20 underwent endovascular embolization, and two underwent both to achieve complete embolization of the lesion. The number of percutaneous procedures increased in the latter half of the study period as the safety and efficacy of the technique were established. No major complications were seen in this study. CONCLUSION Embolization of scalp AVMs is a safe and effective technique and can be used in isolation for small lesions and as an adjunct procedure to surgery for large-sized lesions.
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Affiliation(s)
- Amrin Israrahmed
- Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Vivek Singh
- Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Surya Nandan Prasad
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, India
| | - Anil Kumar Singh
- Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Ankur Bhatnagar
- Department of Plastic Surgery and Burns, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Anupama Singh
- Department of Plastic Surgery and Burns, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Tempesta A, Dell'Olio F, Siciliani RA, Favia G, Capodiferro S, Limongelli L. Targeted Diode Laser Therapy for Oral and Perioral Capillary-Venous Malformation in Pediatric Patients: A Prospective Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040611. [PMID: 37189860 DOI: 10.3390/children10040611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study describes the management protocol for capillary-venous malformations in pediatric patients and reports the epidemiology of diagnosed and treated cases at the Unit of Odontostomatology of the Aldo Moro University of Bari from 2014 to 2022. METHODS The authors classified the intraoral and perioral capillary-venous malformations by superficial diameter (<1 cm, 1-3 cm, >3 cm) and ultrasonographical depth extension (≤5 mm, >5 mm). All patients underwent pulsed-mode diode laser transmucosal photocoagulation (8-12 W/cm2); those with malformations that were wide (>3 cm) and deep (>5 mm) received intralesional photocoagulation, too (13 W/cm2). The children received general anesthesia based on their compliance and lesions' extension. The follow-up lasted six months. RESULTS A total of 22 females and 14 males (age range 4-18 years) presented 63 capillary-venous malformations. Five patients with Sturge-Weber syndrome, seven with hereditary hemorrhagic telangiectasia, and five with angiomatosis showed multiple malformations. The authors found no intraoperative or postoperative complications. Seventeen patients with lesions >1 cm and >5 mm deep required multiple laser sessions to heal. CONCLUSION The results of the current study support diode laser photocoagulation as the gold standard for the treatment of intraoral and perioral capillary-venous malformations in pediatric patients.
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Affiliation(s)
- Angela Tempesta
- Complex Operating Unit of Odontostomatology, Department of Interdisciplinary Medicine, Aldo Moro University, 70121 Bari, Italy
| | - Fabio Dell'Olio
- Complex Operating Unit of Odontostomatology, Department of Interdisciplinary Medicine, Aldo Moro University, 70121 Bari, Italy
| | - Rosaria Arianna Siciliani
- Complex Operating Unit of Odontostomatology, Department of Interdisciplinary Medicine, Aldo Moro University, 70121 Bari, Italy
| | - Gianfranco Favia
- Complex Operating Unit of Odontostomatology, Department of Interdisciplinary Medicine, Aldo Moro University, 70121 Bari, Italy
| | - Saverio Capodiferro
- Complex Operating Unit of Odontostomatology, Department of Interdisciplinary Medicine, Aldo Moro University, 70121 Bari, Italy
| | - Luisa Limongelli
- Complex Operating Unit of Odontostomatology, Department of Interdisciplinary Medicine, Aldo Moro University, 70121 Bari, Italy
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13
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Lavé A, Yilmaz H, Rosi A, Paun L, Patet G, Bartoli A. Combined sclerotherapy followed by surgical resection of a large extracranial venous malformation in a 14-month-old child: preoperative workup and technical note. Childs Nerv Syst 2023; 39:527-533. [PMID: 35962221 PMCID: PMC10006260 DOI: 10.1007/s00381-022-05643-z] [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: 05/26/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Venous malformations affect around 2 per 10,000 newborn and are the most common type of congenital vascular malformation. They are always present at birth and are often misdiagnosed with hemangiomas. Accurate diagnosis and adequate targeted therapy through a multidisciplinary approach is advocated for a successful treatment, considering a combination of modalities in complex cases. We present here the workup and treatment of a venous malformation in a 14 month old child by combining a preoperative sclerotherapy with sodium tetradecyl sulfate (STS) followed by complete surgical excision respecting the calvarium. CASE PRESENTATION A large right extracranial fronto-parietal venous malformation and scalloping of the underlying calvarium, attached to the pericranium, surgically excised after preoperative sclerotherapy with STS in a 14-month-old child. RESULTS The patient had an uneventful postoperative course with complete resection of the lesion, satisfying cosmetic appearance and no complications. Histopathological examination confirmed a venous malformation. CONCLUSION We demonstrated the workup and the rationale of the combined sclerotherapy followed by surgical resection of a large growing extracranial venous malformation. Preoperative direct contrast injection and sclerotherapy allowed to rule out significative extracranial to intracranial venous inflow and reduce blood loss for the surgical procedure, respectively. Complete removal of the malformation minimized the impact on future growth of the calvarium.
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Affiliation(s)
- Alexandre Lavé
- Division of Neurosurgery, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
| | - Hasan Yilmaz
- Division of Diagnostic and Interventional Neuroradiology, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Andrea Rosi
- Division of Diagnostic and Interventional Neuroradiology, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Luca Paun
- Division of Neurosurgery, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Gildas Patet
- Division of Neurosurgery, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Andrea Bartoli
- Division of Neurosurgery, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
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14
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Zhang X, Wang N, Yang B. Renal venous malformation misdiagnosed as carcinoma: A report of one case and the review of literature. Int J Immunopathol Pharmacol 2023; 37:3946320231214117. [PMID: 37941159 PMCID: PMC10637163 DOI: 10.1177/03946320231214117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
The present study reports the clinical data of a patient with renal venous malformation misdiagnosed as carcinoma. CT revealed hematocele in the left renal pelvis and ureter. CTU: the left renal pelvis and calyces showed a slightly high density shadow, a size of about 2.6 cm*1.5 cm, and mild-to-moderate enhancement was found at the edge of the lesion. Enhanced MR showed that irregular mass abnormal signal was observed in the lower calyx of the left kidney and the lesions were cast, with short T1 and slightly long T2 signals. The secondary bleeding or mucus of low-grade malignant tumor became suspicious. The patient underwent cystoscopy and left ureteroscopy under general anesthesia on December 3, 2021. Bloody urine can be seen on the left side, and multiple blood clots in the left renal pelvis can be detected. After washing, dark red bloody necrotic substances can be seen. Pathology suggests that renal venous malformation, accompanied by bleeding and thrombosis, is located in the renal medulla, involving the renal calyx, rupture and bleeding of the renal calyx, and obvious local bleeding of surrounding renal tissue. Follow-up for more than 1 year showed that the patient's condition was stable. When patients have renal colic with hematuria, enhanced CT suggests that renal mass is mild-to-moderate continuous enhancement, enhanced MRI suggests short T1 and long T2, considering that the mass may be accompanied by bleeding, and ureteroscopy suggests that dark red bloody necrotic substances should be considered in the diagnosis of renal venous malformation.
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Affiliation(s)
- Xinchun Zhang
- Department of Radiology, Hangzhou Tianshui Wulin Srteet Community Health Service Centers, Hangzhou, China
| | - Ning Wang
- Department of Medical Examination Center, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Bingkui Yang
- Department of Radiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
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15
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Krt A, Cemazar M, Lovric D, Sersa G, Jamsek C, Groselj A. Combining superselective catheterization and electrochemotherapy: A new technological approach to the treatment of high-flow head and neck vascular malformations. Front Oncol 2022; 12:1025270. [DOI: 10.3389/fonc.2022.1025270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/07/2022] [Indexed: 11/30/2022] Open
Abstract
IntroductionThe study aims to demonstrate a combination of superselective catheterization and electrochemotherapy as a feasible and effective new technological approach in treating high-flow vascular malformations of the head and neck region.Patients and methodsIn the patient with high-flow arteriovenous malformation of the lower lip, superselective catheterization was performed under general anesthesia. The microcatheter was used to administer 750 IU BLM intra-arterially into the feeding vessel. The whole malformation surface was then covered with 15 applications of electric pulses using the plate electrode.ResultsExcellent response, without functional or aesthetic deficits, was obtained in 10 weeks. During this period, debridement and necrectomy were performed regularly on follow-up visits. The pain was managed with oral paracetamol and sodium metamizole.ConclusionCombining electrochemotherapy using bleomycin with superselective catheterization and arteriography is a feasible treatment option for high-flow vascular malformations in the head and neck region and could play a significant role in managing these challenging lesions.
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16
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Ismail M, Al-Ageely TA, Talib SH, Hadi RT, Al-Taie RH, Aktham AA, Alrawi MA, Salih HR, Al-Jehani H, Hoz SS. Atypical slow-flow paramedian AVM with venous varix. Surg Neurol Int 2022; 13:519. [DOI: 10.25259/sni_920_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background:
Cerebral arteriovenous malformations (CAVMs) are either clinically silent or symptomatic. The most common presentation in more than half of all CAVMs presenting patients is hemorrhage which is accompanied by long-standing neurological morbidity and mortality. This report presents a case of an atypical large, slow-flow paramedian AVM with a dilated venous varix managed with surgery. The impact of the intraoperative findings on the diagnosis and the operative technique will be discussed.
Case Description:
In otherwise, healthy 26-year-old male complained of repeated episodes of generalized seizures and loss of consciousness. Brain magnetic resonance imaging (MRI) revealed a right parietal paramedian arteriovenous malformation (AVM) with signs of an old hemorrhagic cavity beneath it. Digital subtraction angiography demonstrated a slow-filling AVM with dilated venous varix drains into the superior sagittal sinus. However, the exact point of drainage cannot be appreciated. The filling of the AVM occurred precisely with the beginning of the venous phase. Intraoperatively, we noticed a whitish spherical mass, thick hemosiderin tissue, and a large cavity below the nidus; then, a complication-free complete microsurgical resection of this high-grade AVM was performed. Postoperatively, the patient suffered two attacks of seizures in the first few hours after the surgery, for which he received antiepileptics. MRI was clear during follow-up, and the patient was seizure-free and neurologically intact.
Conclusion:
Parietal convexity AVMs are challenging lesions to tackle. However, the chronicity and the slow-filling of the AVM, in this case, can render the surgical pathway more direct and accessible.
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Affiliation(s)
- Mustafa Ismail
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Teeba A. Al-Ageely
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Sura H. Talib
- Department of Neurosurgery, University of Al-Mustansiriyah, College of Medicine, Baghdad, Iraq,
| | - Rania Thamir Hadi
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Rania H. Al-Taie
- Department of Neurosurgery, University of Al-Mustansiriyah, College of Medicine, Baghdad, Iraq,
| | - Awfa A. Aktham
- Department of Neurosurgery, Tokyo General Hospital, Nakano, Japan,
| | - Mohammed A. Alrawi
- Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq,
| | - Hayder R. Salih
- Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq,
| | - Hosam Al-Jehani
- Department of Neurosurgery, Imam Abdulrahman Alfaisal University, Dammam, Saudi Arabia,
| | - Samer S. Hoz
- Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, United States
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17
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Souza LL, Roza ALOC, Leite AA, Gallagher KPD, Mariz BALA, Santos MRG, Santos-Silva AR, Vargas PA. A PIGMENTED NODULE IN THE BUCCAL MUCOSA. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:465-469. [PMID: 36153301 DOI: 10.1016/j.oooo.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Affiliation(s)
- L L Souza
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Amanda Almeida Leite
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | | | - Mariana Rates Gonzaga Santos
- Department of Immunology, Science Biological Institute, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil; Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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18
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Dorrity J, Mack J, Wong K, Richter GT. Multimodality Treatment of Vascular Anomalies of The Head And Neck. J Oral Pathol Med 2022; 51:860-871. [PMID: 35674677 DOI: 10.1111/jop.13322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Abstract
Vascular anomalies affect up to 5% of children with the majority affecting the head and neck. They present at different ages as a wide variety of lesions. Careful evaluation with history, physcial examination and imaging assist in the proper diagnosis. Depending on the condition, treatment options for vascular anomalies include topical therapy, selective photothermolysis, sclerotherapy, embolization, surgical excision and targeted systemic therapy. Staged multimodal therapeutic regimens have proven to best control disease and allow for preservation of function and aesthetics. The timing, sequence and combination of therapies is best determined by a multidisciplinary vascular anomalies team. Patients and families need to be counseled on anticipated positive outcomes following a protracted course of treatment for the majority of vascular anomalies.
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Affiliation(s)
- Jeffrey Dorrity
- University of Arkansas for Medical Sciences Department of Otolaryngology-Head and Neck Surgery, 4801 W Markham, Little Rock, AR
| | - Joana Mack
- University of Arkansas for Medical Sciences Department of Otolaryngology-Head and Neck Surgery, 4801 W Markham, Little Rock, AR
| | - Kevin Wong
- University of Arkansas for Medical Sciences Department of Otolaryngology-Head and Neck Surgery, 4801 W Markham, Little Rock, AR
| | - Gresham T Richter
- University of Arkansas for Medical Sciences Department of Otolaryngology-Head and Neck Surgery, 4801 W Markham, Little Rock, AR
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19
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Coulie J, Boon L, Vikkula M. Molecular Pathways and Possible Therapies for Head and Neck Vascular Anomalies. J Oral Pathol Med 2022; 51:878-887. [PMID: 35610188 DOI: 10.1111/jop.13318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
Vascular Anomalies are a heterogenous group of vascular lesions that can be divided, according to the International Society for the Study of Vascular Anomalies Classification, into two main groups : Vascular Tumors and Vascular Malformations. Vascular Malformations can be further subdivided into slow-flow and fast-flow malformations. This clinical and radiological classification allows for a better understanding of vascular anomalies and aims to offer a more precise final diagnosis. Correct diagnosis is essential to propose the best treatment, which traditionally consists of surgery, embolization or sclerotherapy. Since a few years, medical treatment has become an important part of multidisciplinary treatment. Genetic and molecular knowledge of vascular anomalies are increasing rapidly and opens the door for a molecular classification of vascular anomalies according to the underlying pathways involved. The main pathways seem to be: PI3K/AKT/mTOR (PIKopathies) and RAS/RAF/MEK/ERK (RASopathies). Knowing the underlying molecular cascades allows us to use targeted medical therapies. The first part of this article aims to review the vascular anomalies seen in the head and neck region and their underlying molecular causes and involved pathways. The second part will propose an overview of the available targeted therapies based on the affected molecular cascade. This article summarizes theragnostic treatments available in vascular anomalies.
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Affiliation(s)
- Julien Coulie
- Center for Vascular Anomalies, Division of Plastic Surgery, VASCERN VASCA European Reference Centre, Saint Luc University Hospital, Brussels, Belgium.,Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium
| | - Laurence Boon
- Center for Vascular Anomalies, Division of Plastic Surgery, VASCERN VASCA European Reference Centre, Saint Luc University Hospital, Brussels, Belgium.,Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium
| | - Miikka Vikkula
- Center for Vascular Anomalies, Division of Plastic Surgery, VASCERN VASCA European Reference Centre, Saint Luc University Hospital, Brussels, Belgium.,Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium
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20
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Abdolrahimzadeh S, Formisano M, Marani C, Rahimi S. An update on the ophthalmic features in hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber syndrome). Int Ophthalmol 2022; 42:1987-1995. [PMID: 35034241 PMCID: PMC9156511 DOI: 10.1007/s10792-021-02197-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/18/2021] [Indexed: 11/29/2022]
Abstract
Hereditary haemorrhagic telangiectasia (HHT) or Osler-Rendu-Weber syndrome is a rare autosomal dominant disease, characterised by systemic angiodysplasia. Dysfunction of the signalling pathway of β transforming growth factor is the main cause of HHT principally owing to mutations of the genes encoding for endoglin (ENG) and activin A receptor type II-like 1 (ACVRL1). Clinical manifestations can range from mucocutaneous telangiectasia to organ arterio-venous malformations and recurrent epistaxis. The early clinical manifestations may sometimes be subtle, and diagnosis may be delayed. The main ophthalmic manifestations historically reported in HHT are haemorrhagic epiphora, and conjunctival telangiectasia present in 45-65% of cases, however, imaging with wide-field fluorescein angiography has recently shown peripheral retinal telangiectasia in 83% of patients. Optimal management of HHT requires both understanding of the clinical presentations and detection of early signs of disease. Advances in imaging methods in ophthalmology such as wide-field fluorescein angiography, spectral domain optical coherence tomography, and near infrared reflectance promise further insight into the ophthalmic signs of HHT towards improved diagnosis and early management of possible severe complications.
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Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Neurosciences, Mental Health and Sense Organs (NESMOS) Department, University of Rome Sapienza, Rome, Italy. .,Faculty of Medicine and Psychology, St. Andrea Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
| | - Martina Formisano
- Department of Sense Organs, Ophthalmology Unit, University of Rome Sapienza, Azienda Policlinico Umberto I, viale del Policlinico 155, 00161, Rome, Italy
| | - Carla Marani
- San Carlo Hospital, Via Aurelia 275, 00165, Rome, Italy
| | - Siavash Rahimi
- Istituto Dermopatico dell'Immacolata (IDI-IRCCS) Department of Histopathology, Via Monti di Creta 104, 00167, Rome, Italy
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21
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Souza Junior EFD, Sena DAC, Lucena VRDS, Souza LBD, Morais HHAD. Malformação venolinfática em borda lateral de língua: relato de caso. J Vasc Bras 2022; 21:e20200113. [PMID: 35399344 PMCID: PMC8958432 DOI: 10.1590/1677-5449.200113] [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: 06/26/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022] Open
Abstract
Vascular malformations are vascular anomalies that can affect veins, lymphatic vessels, and/or arteries in isolated or mixed form. When they present in the mixed form with venous and lymphatic involvement, they are called venolymphatic or lymphatic-venous malformations, depending on their predominant component. Although these are benign disorders with good prognosis, they are locally invasive and may lead to deformity, while there is also a propensity for local recurrence. This article presents a case of venolymphatic malformation with unusual localization on the lateral border of the tongue, addressing the clinical conduct and the current theoretical framework.
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22
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Morvant SW, Maroda AJ, Reed LF, Sheyn AM, Peterson J, Elijovich L, Michael LM, DiNitto JM, Rangarajan SV. Endoscopic Endonasal Treatment of a Sinonasal Vascular Neoplasm in the Postnatal Period: Case Report and Review of Literature. Ann Otol Rhinol Laryngol 2021; 131:1287-1292. [PMID: 34918575 DOI: 10.1177/00034894211061992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Congenital vascular lesions commonly present in the head and neck, and most are managed conservatively. Location and rapid growth, however, may necessitate surgical intervention. Endoscopic endonasal surgery (EES) in the pediatric population has emerged as a viable option in treating sinonasal and skull base lesions. Utilizing these techniques in newborns carries unique challenges. The objective of this report is to describe the successful use of direct intralesional embolization followed by endoscopic endonasal resection of a venous malformation in a postnatal patient. METHODS We reviewed the case reported and reviewed the pertinent literature. RESULTS A 6-week-old infant was found to have a large right-sided sinonasal lesion confirmed as a venous malformation. Rapid growth, impending orbital compromise, and potential long-term craniofacial abnormalities demanded the need for urgent surgical intervention. Risk of bleeding was mitigated with direct intralesional embolization. Immediately afterward, the patient underwent endoscopic endonasal resection of the lesion. EES in the very young presents multiple challenges both anatomically and behaviorally. A multidisciplinary approach lead to a successful outcome. CONCLUSION We report a case of a 6-week-old infant, the youngest reported patient to the authors' knowledge, who successfully underwent direct intralesional embolization followed by endoscopic endonasal resection of a sinonasal vascular malformation. This report highlights the challenges of this technique in the very young and demonstrates it as a viable treatment strategy for sinonasal vascular anomalies in this population.
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Affiliation(s)
- Stephen W Morvant
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Andrew J Maroda
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Leighton F Reed
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Anthony M Sheyn
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jeremy Peterson
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Lucas Elijovich
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - L Madison Michael
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Julie M DiNitto
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Siemens Medical Solutions, Malvern, PA, USA
| | - Sanjeet V Rangarajan
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
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23
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Ho ML. Pediatric Neck Masses: Imaging Guidelines and Recommendations. Radiol Clin North Am 2021; 60:1-14. [PMID: 34836558 DOI: 10.1016/j.rcl.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Neck masses commonly present in children and several potential diagnostic and management pathways exist, though with a paucity of evidence-based recommendations. The purpose of this article is to evaluate the current literature and utilization of various diagnostic imaging modalities , with a review of imaging features and management pearls for pediatric neck masses. A comprehensive understanding and practical imaging workflow will guide optimal patient workup and management.
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Affiliation(s)
- Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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24
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Anh TT, Nguyen QL, Thi QM, Minh TP. Digital Subtraction Angiography-Guided Foam Sclerotherapy with Polidocanol for Treating Superficial Venous Malformation. Ann Vasc Dis 2021; 14:231-235. [PMID: 34707744 PMCID: PMC8474081 DOI: 10.3400/avd.oa.20-00164] [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: 11/25/2020] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aims to describe the angiographic imaging characteristics of superficial venous malformations and evaluate the treatment effectiveness of digital subtraction angiography (DSA)-guided foam sclerotherapy with polidocanol. Materials and Methods: This prospective study was conducted in 18 patients with venous malformation treated by DSA-guided sclerotherapy. Treatment outcomes were evaluated based on pain improvement and reduction in lesion size on magnetic resonance imaging (MRI) 6-months posttreatment. Results: A total 21 lesions and 46 sclerotherapy sessions were analyzed. MRI findings presented 8/21 lesions (38.1%) with excellent response, 9/21 (42.9%) with good response, and 3/21 (14.3%) with average response, while one patient (4.8%) showed no response. All patients experienced pain. A significant reduction (p<0.01) was observed in the pre- to posttreatment pain score (5.45 and 0.64, respectively). Over a follow-up period of 1–4 years, three out of four patients (75%) in the retrospective cohort experienced recurrence; one patient had an increased lesion size and pain score, while the other two patients only showed an increased lesion size. No severe complications were seen. Conclusion: DSA-guided sclerotherapy with polidocanol is a safe and effective procedure for reducing lesion size and pain in symptomatic patients with superficial venous malformations.
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Affiliation(s)
- Tuan Tran Anh
- Radiology Center, Bach Mai Hospital, Ha Noi, Vietnam.,Radiology Department, Hanoi Medical University, Ha Noi, Vietnam
| | - Quyen Le Nguyen
- Department of Thoracic, Vascular and Neurology, Trung Vuong Hospital, Ho Chi Minh City, Vietnam
| | - Quynh Mai Thi
- Radiology Department, Hanoi Medical University, Ha Noi, Vietnam
| | - Thong Pham Minh
- Radiology Center, Bach Mai Hospital, Ha Noi, Vietnam.,Radiology Department, Hanoi Medical University, Ha Noi, Vietnam
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25
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The Rare Cases of Parotid Gland Arteriovenous Malformations. Case Rep Otolaryngol 2021; 2021:6072155. [PMID: 34513104 PMCID: PMC8429032 DOI: 10.1155/2021/6072155] [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: 07/08/2021] [Accepted: 08/24/2021] [Indexed: 01/09/2023] Open
Abstract
Arteriovenous malformation (AVM) results from errors in vascular development during embryogenesis; absent capillary beds lead to shunting directly from the arterial to venous circulation. Although it is common in the head and neck region, AVMs located in the parotid gland are quite rare. Here, we report two cases of arteriovenous malformation of the parotid gland that presented to our out-patient setup with swelling in the parotid region and were diagnosed as arteriovenous malformation on histopathological study after surgical resection.
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Cullion K, Petishnok LC, Koo H, Harty B, Melero-Martin JM, Kohane DS. Targeting Nanoparticles to Bioengineered Human Vascular Networks. NANO LETTERS 2021; 21:6609-6616. [PMID: 34296614 PMCID: PMC8719414 DOI: 10.1021/acs.nanolett.1c02027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Pharmacotherapy of vascular anomalies has limited efficacy and potentially limiting toxicity. Targeted nanoparticle (NP) drug delivery systems have the potential to accumulate within tissues where the vasculature is impaired, potentially leading to high drug levels (increased efficacy) in the diseased tissue and less in off-target sites (less toxicity). Here, we investigate whether NPs can be used to enhance drug delivery to bioengineered human vascular networks (hVNs) that are a model of human vascular anomalies. We demonstrate that intravenously injected phototargeted NPs enhanced accumulation of NPs and the drug within hVNs. With phototargeting we demonstrate 17 times more NP accumulation within hVNs than was detected in hVNs without phototargeting. With phototargeting there was 10-fold more NP accumulation within hVNs than in any other organ. Phototargeting resulted in a 6-fold increase in drug accumulation (doxorubicin) within hVNs in comparison to animals injected with the free drug. Nanoparticulate approaches have the potential to markedly improve drug delivery to vascular anomalies.
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Affiliation(s)
- Kathleen Cullion
- Laboratory for Biomaterials and Drug Delivery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department of Medical Critical Care, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Laura C Petishnok
- Laboratory for Biomaterials and Drug Delivery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department of Medical Critical Care, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Hyunji Koo
- Laboratory for Biomaterials and Drug Delivery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department of Medical Critical Care, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Brendan Harty
- Laboratory for Biomaterials and Drug Delivery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department of Anesthesiology, Critical Care, and Pain Management, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Juan M Melero-Martin
- Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Daniel S Kohane
- Laboratory for Biomaterials and Drug Delivery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department of Anesthesiology, Critical Care, and Pain Management, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
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Abstract
Vascular and lymphatic malformations represent a challenge for clinicians. The identification of inherited and somatic mutations in important signaling pathways, including the PI3K (phosphoinositide 3-kinase)/AKT (protein kinase B)/mTOR (mammalian target of rapamycin), RAS (rat sarcoma)/RAF (rapidly accelerated fibrosarcoma)/MEK (mitogen-activated protein kinase kinase)/ERK (extracellular signal-regulated kinases), HGF (hepatocyte growth factor)/c-Met (hepatocyte growth factor receptor), and VEGF (vascular endothelial growth factor) A/VEGFR (vascular endothelial growth factor receptor) 2 cascades has led to the evaluation of tailored strategies with preexisting cancer drugs that interfere with these signaling pathways. The era of theranostics has started for the treatment of vascular anomalies. Registration: URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2015-001703-32.
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Affiliation(s)
- Angela Queisser
- Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium (A.Q., L.M.B., M.V.), University of Louvain, Brussels, Belgium (M.V.)
| | - Emmanuel Seront
- Centre for Vascular Anomalies, Division of Plastic Surgery, Cliniques Universitaires Saint-Luc Brussels, Belgium (E.S., L.M.B., M.V.).,Institut Roi Albert II, Department of Medical Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium (E.S.).,VASCERN VASCA European Reference Centre Cliniques Universitaires Saint-Luc, Brussels, Belgium (E.S., L.M.B., M.V.)
| | - Laurence M Boon
- Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium (A.Q., L.M.B., M.V.), University of Louvain, Brussels, Belgium (M.V.).,Centre for Vascular Anomalies, Division of Plastic Surgery, Cliniques Universitaires Saint-Luc Brussels, Belgium (E.S., L.M.B., M.V.).,VASCERN VASCA European Reference Centre Cliniques Universitaires Saint-Luc, Brussels, Belgium (E.S., L.M.B., M.V.)
| | - Miikka Vikkula
- Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium (A.Q., L.M.B., M.V.), University of Louvain, Brussels, Belgium (M.V.).,Centre for Vascular Anomalies, Division of Plastic Surgery, Cliniques Universitaires Saint-Luc Brussels, Belgium (E.S., L.M.B., M.V.).,University of Louvain, Brussels, Belgium (M.V.).,University of Louvain, Brussels, Belgium (M.V.).,Walloon Excellence in Life Sciences and Biotechnology (WELBIO), University of Louvain, Brussels, Belgium (M.V.).,VASCERN VASCA European Reference Centre Cliniques Universitaires Saint-Luc, Brussels, Belgium (E.S., L.M.B., M.V.)
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Bertino F, Trofimova AV, Gilyard SN, Hawkins CM. Vascular anomalies of the head and neck: diagnosis and treatment. Pediatr Radiol 2021; 51:1162-1184. [PMID: 33860862 DOI: 10.1007/s00247-021-04968-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/27/2020] [Accepted: 01/07/2021] [Indexed: 01/19/2023]
Abstract
Vascular malformations and vascular tumors comprise the two specific subsets of vascular anomalies that arise as a result of disorganized angiogenesis and neoplasm, respectively. Malformations are separate entities from vascular tumors (e.g., hemangiomas) and are recognized by the International Society for the Study of Vascular Anomalies (ISSVA) as such. Vascular malformations are classified into four main groups: simple, combined, anomalies of major vessels, and those associated with other vascular anomalies. Vascular tumors are neoplastic growths of blood vessels and are morphologically and molecularly distinct from malformations but can arise in the head and neck and have syndromic association. Head and neck vascular anomalies are not uncommon in the pediatric population and require special care in the workup, diagnostic imaging and clinical care. The purpose of this manuscript is to discuss the diagnosis and management of the most common intracranial and extracranial vascular malformations and tumors in the head and neck in children and adolescents.
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Affiliation(s)
- Frederic Bertino
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road NE, Room BG03, Atlanta, GA, 30322, USA.
| | - Anna V Trofimova
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road NE, Room BG03, Atlanta, GA, 30322, USA
| | - Shenise N Gilyard
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road NE, Room BG03, Atlanta, GA, 30322, USA
| | - C Matthew Hawkins
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road NE, Room BG03, Atlanta, GA, 30322, USA.,Division of Pediatric Radiology, Division of Interventional Radiology and Image Guided Medicine, Children's Healthcare of Atlanta, Emory + Children's Pediatric Institute, Atlanta, GA, USA
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Yuan W, Wang X, Xue L, Zhang F. Clinical evaluation and animal experimental study of different mass concentrations of pingyangmycin in the local injection treatment of lip venous malformation. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:929. [PMID: 34350244 PMCID: PMC8263871 DOI: 10.21037/atm-21-2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/10/2021] [Indexed: 11/06/2022]
Abstract
Background This study investigated the clinical efficacy of different mass concentrations of pingyangmycin in the local injection treatment of lip venous malformation. An animal experimental study of the histopathological effects of different mass concentrations of pingyangmycin on the normal lip tissue of rabbits was also conducted. Methods (I) We retrospectively analysed 98 out-patients with lip venous malformation in the Stomatological Hospital and the Fourth Affiliated Hospital of China Medical University from January 2008 to June 2013. The 98 cases were treated by local injection of different mass concentrations (8 mg/3 mL and 8 mg/5 mL) of pingyangmycin for the different sites of the lips. The clinical efficacy was observed, and adverse reactions were recorded. (II) 60 healthy male rabbits were randomly divided into three groups: a 8 mg/5 mL pingyangmycin group, a 8 mg/3 mL pingyangmycin group, and a control group. The right upper lips of the experimental groups were injected with 1ml pingyangmycin (8 mg/5 mL) and 1ml pingyangmycin (8 mg/3 mL) respectively, and the control group was injected with the same volume of normal saline. The thickness of the right upper lip of rabbits in the experimental groups and the control group was measured on the 21st, 28th, 35th, and 60th days after the first injection. Histopathological changes at the injection site were observed by light microscope and transmission electron microscope. Results Venous malformations involving the skin tissues of the lips (pingyangmycin 8 mg/3 mL) had an effective rate of 93.62%, and those involving the labial mucosa tissues (pingyangmycin 8 mg/5 mL) had an effective rate of 98.04%. In the animal experiment, there were statistically significant differences in the thickness of the injection site among the 8 mg/3 mL group, 8 mg/5 mL group, and the control group at different time points (P<0.01). Conclusions The local injection of pingyangmycin in the treatment of lip venous malformations was efficient, safe and reliable. In the process of clinical application, attention should be paid when the concentration is 8 mg/3 mL to avoid local tissue atrophy and other complications.
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Affiliation(s)
- Weili Yuan
- Department of Stomatology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xukai Wang
- Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Liaoning Institute of Stomatology, Shenyang, Liaoning, China
| | - Lei Xue
- Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Liaoning Institute of Stomatology, Shenyang, Liaoning, China
| | - Fang Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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Chi JM, Hagiwara M. Update on MRI for Oral Cavity. Top Magn Reson Imaging 2021; 30:85-96. [PMID: 33828060 DOI: 10.1097/rmr.0000000000000278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Magnetic resonance imaging (MRI) is the imaging modality of choice to evaluate the complex anatomy and pathology of the oral cavity. In this article, an overview of MRI findings of common benign lesions in the oral cavity including congenital, vascular, and inflammatory/infectious lesions will be reviewed. In addition, MRI findings of common benign and malignant oral cavity tumors will be presented.
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Affiliation(s)
- Joan M Chi
- Department of Radiology, NYU Langone Health, New York, NY
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Arteriovenous malformation in cheek and tongue aggravated by cellulitis: A case report and literature review. Ann Med Surg (Lond) 2021; 63:102196. [PMID: 33717479 PMCID: PMC7933698 DOI: 10.1016/j.amsu.2021.102196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 12/11/2022] Open
Abstract
Arterio-venous malformation (AVM) is a congenital disorder of blood vessels, causing abnormal passage of blood between the artery and vein, which most often results in abnormal development of the vascular system in embryonic life. Arteriovenous malformations of the head and neck pose a challenging therapeutic and reconstructive problem. We present a rare case of a 22-year-old white woman, who complained of facial asymmetry on the right side, evolving after an episode of jugular cellulite of dental origin treated 6 months ago. Clinical examination revealed a palpable nodule measuring approximately 25 mm, soft, painless, of sub-mucosal location and a swollen, bluish right hemi tongue. Ultrasonography was requested, which indicated the hypothesis of a vascular lesion. The microscopic diagnosis was of arterio-venous malformation with thrombus formation. The patient has been followed for 3 months and is without signs of relapse. We treated the cellulite and closely followed the patient.
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Zhang JY, Lan SJ, Liu M, Yang TY, Liu SS, Rong L. Topical Timolol Combined Intralesional Injection of Diprospan in the Treatment of Elevated Localized Mixed Infantile Hemangiomas and a Discussion for Proper Timing for Injection. J Craniofac Surg 2021; 32:988-990. [PMID: 33538448 DOI: 10.1097/scs.0000000000007523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although infantile hemangiomas (IHs) are usually self-limiting, residual elevated appearance may remain. Topical beta-blockers are effective in superficial IHs management, while intralesionally injected diprospan is effective at treating deep, localized IHs. A single application of topical timolol or injected diprospan has obvious limitations. Therefore, for elevated, localized mixed IHs, we applied topical timolol combined with intralesionally injected diprospan, using their respective advantages to maximize benefits. PURPOSE To evaluate the clinical efficacy and safety of topical timolol combined with intralesionally injected diprospan for the treatment of elevated, localized mixed IHs and identify the optimal injection time. METHODS Infants with elevated, localized mixed IHs in the proliferative phase were treated with injected diprospan combined with topical timolol between March 2018 and March 2020. The injection was administered only when the tumor surface was higher than that of the surrounding tissue. The patients were asked to return every 4 weeks for a treatment response evaluation, and complications were recorded. RESULTS Thirty-six patients with elevated, localized mixed IHs (thickness >3 mm on Doppler ultrasound) were recruited. The mean age at treatment initiation was 3.58 ± 1.50 months (range: 1.00-6.00 months). The follow-up period ranged from 9 to 24 months. Considering the size of the IH at the end of treatment, regression was observed in 31 (86.1%) cases, stabilization was observed in 5 (13.9%) cases, and no treatment failure was observed. All the IHs improved in color and height after treatment. CONCLUSION Topical timolol combined with intralesionally injected diprospan is an effective and safe treatment for elevated, localized mixed IH. The injection is needed only when we forecast the elevated tissue may remain after regression.
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Affiliation(s)
- Jing-Yue Zhang
- Department of Plastic and Reconstructive Surgery Department of Hematology and Oncology, First Hospital of Jilin, University, Changchun, China
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Araslanova R, O TMJ, Waner M. Endoscopic Multimodal Approach to the Treatment of Airway Venous Malformations. Laryngoscope 2021; 131:E521-E524. [PMID: 32533772 DOI: 10.1002/lary.28730] [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: 11/30/2019] [Revised: 04/03/2020] [Accepted: 04/17/2020] [Indexed: 11/11/2022]
Abstract
View Video S1
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Affiliation(s)
- Rakhna Araslanova
- Department of Otolaryngology-Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, New York
- Vascular Birthmark Institute of New York, Lenox Hill and Manhattan Eye, Ear, and Throat Hospitals, New York, New York
| | - Teresa Min-Jung O
- Department of Otolaryngology-Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, New York
- Vascular Birthmark Institute of New York, Lenox Hill and Manhattan Eye, Ear, and Throat Hospitals, New York, New York
| | - Milton Waner
- Department of Otolaryngology-Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, New York
- Vascular Birthmark Institute of New York, Lenox Hill and Manhattan Eye, Ear, and Throat Hospitals, New York, New York
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Karunaratne YG, Greer D, Hong LH, Somia N, Wargon O, Adams S. Low-flow vascular malformations of the hand and forearm: a multidisciplinary experience in a tertiary paediatric centre. ANZ J Surg 2021; 91:1739-1743. [PMID: 33475243 DOI: 10.1111/ans.16591] [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: 06/18/2020] [Revised: 11/30/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vascular malformations (VMs) involving the hand and forearm in children provide management challenges due to complex anatomy, indispensable functionality and developmental implications. METHODS The institution's Vascular Registry was searched for patients with hand and arm VMs, supplemented by chart review of included patients. RESULTS Twenty-one patients were identified, 52% male, with mean presenting age 5.2 years. Venous malformations predominated (71%), followed by lymphatic-venous (19%), lymphatic (5%) and glomuvenous (5%). Symptoms included pain (76%), swelling (71%), cosmetic concerns (81%), functional compromise (29%) and stiffness (5%). Imaging modality was ultrasound (100%), and magnetic resonance imaging (71%). Treatment included compression (62%), sclerotherapy (62%) and surgery (24%). Post-sclerotherapy ultrasounds showed complete sclerosis (25%), near complete sclerosis (58%) and partial sclerosis (17%). Post-surgery, patients reported improved cosmesis (80%), size (100%), pain (60%) and function (40%). Complications occurred in 24%, including bleeding, digital ischaemia and thrombosis. Mean follow-up was 3.4 years. CONCLUSION Children with low-flow VMs of the hand and forearm experience significant symptoms and functional limitations. A multidisciplinary approach to management ensures optimal outcomes.
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Affiliation(s)
- Yasiru G Karunaratne
- Department of Paediatric Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia
- Department of Plastic and Reconstructive Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Douglas Greer
- Department of Paediatric Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Ling H Hong
- School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Naveen Somia
- Department of Plastic and Reconstructive Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia
- School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Orli Wargon
- School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
- Department of Dermatology, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Susan Adams
- Department of Paediatric Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia
- School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
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Samal S, Kumar M, Baliarsingh R, Ray P, Mahakur M. Pyogenic granuloma or hemangioma: An insoluble dilemma. INTERNATIONAL JOURNAL OF PEDODONTIC REHABILITATION 2021. [DOI: 10.4103/ijpr.ijpr_4_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Comprehensive Treatment and Vascular Architecture Characteristic of High-Flow Vascular Malformations in Periorbital Regions. J Craniofac Surg 2020; 32:187-192. [PMID: 32969925 DOI: 10.1097/scs.0000000000007088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE This study analyzed the vascular architecture characteristics of high-flow vascular malformations (VMs) in periorbital regions, as well as the treatment and imaging prognosis of occlusion degree of the outflow veins. METHOD The clinical data of 24 patients with high-flow VMs in periorbital regions treated in our center from 2012 to 2019 were analyzed retrospectively, and the vascular architecture characteristics, treatment methods, and follow-up results were recorded. RESULTS The vascular architecture of high-flow VMs in periorbital regions which usually contained the intracranial feeding arteries (24/24,100.0%) and intracranial outflow veins (18/24, 75.0%). The average age of first diagnosis was 23 ± 16 years; the average age of treatment was 37 ± 10 years; the median follow-up time was 42.5 months. Twenty-four patients with high-flow VMs in periorbital regions had 58 treatments in all. The imaging cure was achieved in 6 patients by complete occlusion of outflow veins, and no recurrence was found by DSA. Eighteen patients who get incomplete occlusion of outflow veins were given 49 treatments, and 8 patients had imaging recurrence. Seven patients (7/24, 29.2%) had treatment-related complications in all. CONCLUSIONS Patients with high-flow VMs in periorbital regions are the most complex cases. The prognosis of patients whose outflow veins can be completely occluded is relatively good. The stepwise embolization while preserving organ function is advisable. Nevertheless, the incidence of treatment complications is still high.
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Rayasam S, Mitchell RB, Liu C. A Neck Mass in a 9-Year-Old Child. EAR, NOSE & THROAT JOURNAL 2020; 101:NP80-NP82. [PMID: 32791899 DOI: 10.1177/0145561320948769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Ron B Mitchell
- Department of Otolaryngology Head and Neck Surgery, Chief of Pediatric Otolaryngology, UT Southwestern and Children's Medical Center Dallas, TX, USA
| | - Christopher Liu
- Division of Pediatric Otolaryngology, Department of Otolaryngology Head and Neck Surgery, UT Southwestern and Children's Medical Center Dallas, TX, USA
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Swollen Painful Neck: A Case of a Ruptured Venous Malformation. Ann Vasc Surg 2020; 69:453.e1-453.e4. [PMID: 32653614 DOI: 10.1016/j.avsg.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/18/2020] [Accepted: 07/02/2020] [Indexed: 11/23/2022]
Abstract
A 16-year-old male was brought to our hospital presenting with acute onset of a painful protruding left neck mass within a day, associated with left upper-arm tenderness. Chest computed tomography revealed high attenuation masses at the left supraclavicular and mediastinal regions, suspected of being venous vascular tumors. Surgery was arranged and then ruptured venous tumor was noted, with pathology results determining a venous malformation.
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Zeevi I, Chaushu G, Alterman M, Chaushu L. Sclerotherapy of Vascular Malformations in the Oral Cavity-Minimizing Postoperative Morbidity. MEDICINA-LITHUANIA 2020; 56:medicina56050254. [PMID: 32456057 PMCID: PMC7279465 DOI: 10.3390/medicina56050254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/16/2022]
Abstract
Vascular malformations (VMs) are a wide vascular or lymphatic group of lesions common on the head and neck. The objective of this study was to assess the efficacy and morbidity of sclerotherapy for the treatment of VMs in the oral and perioral area. Special attention was given to factors that may contribute to minimizing postoperative morbidity. Data from 25 patients (32 lesions) with oral VMs submitted to sclerotherapy with monoethanolamine oleate (EAO) were included. A structured form was used to collect data. An arbitrary score was determined to evaluate postoperative morbidity. Each of the following signs or symptoms received one point: pain, swelling, hematoma, ulceration, erythema, transient numbness, and transient itching. Pain and swelling were further divided into mild to moderate (1 point) and severe (2 points). Theoretically, the score was in the range of 0–9. Calculated scores ranged 0–4. The patients were further divided into two groups with scores of 0–1 denoting minimal morbidity (MIN) and 2–4 denoting significant morbidity (SIG). The number of lesions in each morbidity-score group were comparable (MIN 17and SIG 15). There were no statistically significant differences between the groups regarding age, number of applications, or average injection volume per mm lesion. Statistically significant differences were noted regarding gender (p = 0.05), lesion diameter (p = 0.030), total volume of first (p = 0.007) and second application (p = 0.05), and total injected volume (p = 0.03). Factors contributing to the risk for significant morbidity included being male, lesion diameter > 5 mm, volume > 0.3 mL per application, and total injected volume > 0.3 mL. A waiting time of 12 weeks prior to additional EAO application was required in 12 out of 29 lesions for clinical observation of complete regression. It was concluded that sclerotherapy with EAO as monotherapy is easy to apply, safe, and effective within a small number of sessions. Application of <0.3 mL EAO per session, and a waiting time of 12 weeks prior to the second application, would significantly minimize morbidity.
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Affiliation(s)
- Itai Zeevi
- Department of Oral and Maxillofacial Surgery, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel; (I.Z.); (M.A.)
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tel Aviv University, Tel-Aviv 69978, Israel;
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Campus Beilinson, Petah Tiqwa 49100, Israel
| | - Michael Alterman
- Department of Oral and Maxillofacial Surgery, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel; (I.Z.); (M.A.)
| | - Liat Chaushu
- Department of Periodontology and Implant Dentistry, School of Dental Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Correspondence:
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Kerr AM, Thompson CM, Rubinsky V. Memorable Messages Parents of Children with Vascular Birthmarks Receive from Others: Implications for Stigma and Identity. HEALTH COMMUNICATION 2020; 35:685-695. [PMID: 30793957 DOI: 10.1080/10410236.2019.1582314] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Parents of children with visible illnesses and physical differences, such as vascular birthmarks (VBs), often fear that their child will be stigmatized by others. Despite their use of various strategies to minimize this stigma, parents still frequently receive comments and questions from others about their child's condition. In the current study, we explore the source, content, and valence of these messages using a memorable messages framework. We also examine how parents react to messages from others and why those messages are considered memorable. To collect data, we administered a cross-sectional online survey through the website and social media pages of a national support group for parents of children with vascular birthmarks. A total of 70 parents completed the survey and, altogether, recalled 92 memorable messages. Our analyses revealed that the significance of the memorable messages coalesced around identity. Specifically, the messages described carried implications for a) participants in terms of their identities as parents, and b) participants' children in terms of their identities as stigmatized individuals. When messages were directed at parents, parents appraised them negatively or positively to the extent that they made parents feel judged or validated as parents of children with VBs. When messages were directed at children, parents appraised them negatively or positively to the extent that they labeled children and their VB as abnormal, unattractive, and undesirable, or accepted and complimented children as unique, special, and beautiful. The current research extends previous research exploring the role of memorable messages in negotiating identity.
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Affiliation(s)
- Anna M Kerr
- Department of Family Medicine, Heritage College of Osteopathic Medicine, Ohio University
| | - Charee M Thompson
- Department of Communication, College of Liberal Arts and Sciences, University of Illinois Urbana Champaign
| | - Valerie Rubinsky
- School of Communication Studies, Scripps College of Communication, Ohio University
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Uncertainty Management and Decision Making: Parents' Experiences During their First Visit to a Multidisciplinary Clinic for their Child's Vascular Anomaly. J Pediatr Nurs 2020; 52:18-24. [PMID: 32106036 DOI: 10.1016/j.pedn.2020.02.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To gain a better understanding of parental decision making in situations of uncertainty and multidisciplinary care, we explored parents' decision-making experiences while seeking care for their child's vascular anomaly at a multidisciplinary clinic at a large Midwestern children's hospital. DESIGN AND METHODS We collected data using semi-structured interviews with 29 parents after they met with multiple specialists for the care of their child's vascular anomaly. RESULTS The findings revealed parents' attempts to manage decision-related uncertainty about their child's vascular anomaly included seeking information, avoiding information, and seeking support from the specialists. Parents described how information management both facilitated and obstructed decision making. CONCLUSIONS Overall, the study reveals several benefits and challenges of making decisions about the management of uncertain childhood conditions, like vascular anomalies, in a multidisciplinary context. The information-rich environment produces information-management dilemmas that challenge parents' decision making efforts. Therefore, parents relied on the support of the team of specialists to make decisions about their child's treatment. PRACTICE IMPLICATIONS The study offers practical implications concerning the barriers of autonomy in decision making. Healthcare professionals should acknowledge the potential for parents' to have shifting information and decision-making goals and preferences, and should explicitly support parents throughout the decision-making process.
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Cho SJ, Lee JH, Chung SR, Choi YJ, Baek JH. Radiofrequency Ablation of Facial Venolymphatic Malformations: Assessment of Efficacy and Safety and the Role of Injectable Electrodes. J Vasc Interv Radiol 2020; 31:544-550. [DOI: 10.1016/j.jvir.2019.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/22/2019] [Accepted: 04/07/2019] [Indexed: 02/07/2023] Open
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Management of massive venous malformations by percutaneous injection of bleomycin combined with fibrin glue in the head and neck. J Craniomaxillofac Surg 2020; 48:488-493. [PMID: 32222354 DOI: 10.1016/j.jcms.2020.02.024] [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: 08/17/2019] [Revised: 11/20/2019] [Accepted: 02/10/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the effectiveness of percutaneous injection of bleomycin combined with fibrin glue in treating massive venous malformations (MVMs) in the head and neck region. MATERIALS AND METHODS A retrospective case series analysis of 22 patients who underwent percutaneous sclerotherapy between June 2015 and December 2018 was performed. All the patients were examined by comparing the size of the venous malformations (VMs) and their responses to treatment including complications in the follow-up. RESULTS The follow-up period ranged from 6 to 24 months. Ten patients (10/22) were completely cured and 10 patients (10/22) exhibited excellent size reduction of their VMs. Two patients (2/22) exhibited reasonable size reduction and were recommended to undergo a second sclerotherapy procedure. However, both patients were satisfied with the outcomes and refused subsequent treatment. Neither systemic nor local complications occurred in this study. All the patients were satisfied with their significant size reductions and symptom improvements without recurrences during follow-up. CONCLUSION Percutaneous injection of bleomycin combined with fibrin glue is a promising treatment option that yielded excellent size reduction with a low risk of complications on MVMs in the head and neck region.
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Manzano BR, Premoli AM, Santaella NG, Ikuta CRS, Rubira CMF, Santos PSDS. Sclerotherapy as an esthetic indication in oral vascular malformations: a case series. An Bras Dermatol 2019; 94:521-526. [PMID: 31777351 PMCID: PMC6857549 DOI: 10.1016/j.abd.2019.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 06/26/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The use of monoethanolamine oleate 5% is effective for the treatment of vascular malformations with low blood flow. OBJECTIVES To report a case series of vascular malformations in the mouth and oral cavity treated with monoethanolamine oleate 5%. METHODS A retrospective descriptive study was performed in electronic patient charts covering seven years. Patient demographics, diagnostic resources, lesion site, size, and number of applications of monoethanolamine oleate 5% were collected. RESULTS A total of 21 vascular malformations were recorded, located mostly on the lower lip (52.3%) and resolved in a single application in 14 patients. The authors found 19 patients treated with sclerotherapy. Thirteen were women and six were men, with a mean age of 61 years. STUDY LIMITATION Small sample size. CONCLUSIONS Sclerotherapy is an effective treatment for vascular malformations of the lips and oral cavity, with resolution after only one or two applications (n=16).
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Affiliation(s)
- Brena Rodrigues Manzano
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil.
| | - Aloizio Maciel Premoli
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Natalia Garcia Santaella
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Carla Renata Sanomiya Ikuta
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Cássia Maria Fisher Rubira
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology, and Radiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
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Panditray S, Acharya S, Prusty N, Dany SS. Management of Head and Neck Hemangiomas in Adults: Oral Propranolol Versus Oral Itraconazole in Conjugation with Injection Sodium Tetra Decyl Sulphate. Indian J Otolaryngol Head Neck Surg 2019; 71:566-573. [PMID: 31742022 DOI: 10.1007/s12070-018-1410-8] [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: 01/09/2018] [Accepted: 05/22/2018] [Indexed: 10/14/2022] Open
Abstract
Management of head and neck hemangiomas with oral propranolol versus oral itraconazole in conjugation with injection sodium tetra decyl sulphate. This prospective parallel clinical trial was done to check for the effectiveness of oral propranolol and oral itraconazole when used in conjugation with inj. sodium tetra decyl sulphate in treatment of head and neck haemangiomas in adult patients visiting department of ENT and head and neck surgery, VIMSAR, Burla. All the patients visiting the department with hemangioma (diagnosed clinically and by FNAC) were considered and only those who gave written informed consent and were according to our inclusion and exclusion criteria were included into the study as subjects. Dimension (length, width and hemi-circumference) of the haemangiomas were measured using disposable paper taper measures. Depth of the hemangioma was calculated based on formula and using that volume was calculated both at baseline and after 8 weeks of drug administration. Data so collected was entered into Microsoft Office Excel 2013 and statistical analysis was performed using SPSS Version 20.0. Descriptive statistics was calculated and student's t test (paired and unpaired) was used to compare within the group (before and after) and between the groups respectively. Statistical significance was set at p ≤ 0.05. Both the groups showed statistically significant volume reduction in the lesions [p < 0.018 (propranolo + sodium tetra decyl sulphate), p < 0.025 (itraconazole + sodium tetra decyl sulphate)]. The mean decrease in volume in propranolol group was 91.92% and that in itraconazole group was 88.97%. There was no statistical difference between the final outcome of both the groups (p < 0.766) but 3 patients on propranolol had complete resolution while 1 patient on itraconazole had complete resolution of the lesion. Oral propranolol and itraconazole are both effective and safe in hemangioma in adults. The combination with inj. sodium tetra decyl sulphate has a (1) favorable impact on decreasing the overall duration of treatment. (2) Aiding in complete resolution of lesions (especially < 3 cm). Propranolol has an edge over itraconazole (more no of tumors had complete resolution).
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Affiliation(s)
- Siddharth Panditray
- Department of ENT and Head Neck Surgery, VSSIMSAR, Burla, Odisha 768017 India
| | - Sauvagini Acharya
- Department of ENT and Head Neck Surgery, VSSIMSAR, Burla, Odisha 768017 India
| | - Nilamadhab Prusty
- Department of ENT and Head Neck Surgery, VSSIMSAR, Burla, Odisha 768017 India
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Gao X, Li Y, Meng L, Tong Z, Guo L, Zhang J, Gu Y. A Vascular Malformation in the Carotid Sheath at the Carotid Bifurcation Mimicking Carotid Body Tumor. Vasc Endovascular Surg 2019; 54:195-197. [PMID: 31597540 DOI: 10.1177/1538574419879849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The carotid sheath contains clinically important and vital anatomical neurogenic, vascular, and lymphatic structures that allow for a great variety of lesions. Vascular anomalies found in the carotid sheath are rarely reported and may be easily misdiagnosed as arterial aneurysms, neurogenic tumors, paragangliomas, or lymphatic masses. METHOD We present a 60-year-old woman with a vascular malformation arising within the carotid sheath at the right carotid bifurcation, which mimics carotid body tumor. RESULT The mass was excised successfully with an uneventful postoperative course, and histological analysis suggested a vascular malformation with thin-walled blood vessels, lined by endothelial cells and separated by fibrous tissue. The patient was in good clinical condition without signs of relapse of the mass at 6-month follow-up. CONCLUSION Vascular malformation is a rare but existing possibility of pathology in the carotid sheath, which can be effectively removed by meticulous surgery.
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Affiliation(s)
- Xixiang Gao
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yang Li
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Liang Meng
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhu Tong
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lianrui Guo
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jian Zhang
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yongquan Gu
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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Gruza A, Ferreira L. Clinical pathologic conference case 4: recurrent gingival growth in the anterior maxilla. Oral Surg Oral Med Oral Pathol Oral Radiol 2019. [DOI: 10.1016/j.oooo.2019.02.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Combined percutaneous sclerotherapy and plastic surgery for the treatment of lower lip venous malformation. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2019.101271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Mukul SK, Singh A, Kumar A, Pandey S, Singh S, Kumar A. Foam Polidocanol Sclerotherapy for Low-Flow Vascular Malformations of Tongue. Ann Maxillofac Surg 2019; 9:257-260. [PMID: 31909004 PMCID: PMC6933997 DOI: 10.4103/ams.ams_81_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Low-flow vascular malformations (LFVMs) of the tongue are one of the most common presentations among different vascular anomalies of oral and maxillofacial regions. The present study was conducted with the objective to assess the outcome of a simple, easily available, safe and cost-effective therapeutic measure using foamed polidocanol in patients with LFVMs of the tongue. MATERIALS AND METHODS Fifteen patients with LFVMs of tongue were randomly selected in the study from the pool of 32 individuals affected with vascular malformation of oral and maxillofacial region. The diagnosis was made by a combination of clinical presentation and Doppler ultrasound. Lesions on the tongue were measured along their longer axis using a calliper and assigned to one of the three groups according to size: small-sized (<1 cm; 3 patients), medium-sized (between 1 and 3 cm; Four patients), or large-sized (>3 cm; eight patients). Foam sclerotherapy was done by directly injecting the foam (polidocanol) into identified sinusoids, under real-time ultrasound guidance. Foam polidocanol was prepared using the Tessari method. RESULTS Fifteen patients (Nine males and Six females), aged 7-50 years, with an average age of 23.53 years were included in our study. Of these 15 vascular lesions, three were small (<1 cm), four were medium (1-3 cm) and eight were large (>3 cm) in size. Treatment results were evaluated based on a reduction in lesion size. Complete or partial regression of lesions was reported by 14 (93.33%) patients and remained unchanged in one (6.67%) patient. The number of sclerotherapy sessions performed in this study ranged from 1 to 6 and was directly related to lesion size. Small- and medium-sized lesions responded well and complete resolution was seen in 1-3 sessions. Of the eight large lesions, seven showed complete or partial resolution in 4-6 sessions except one lesion which did not show any responses in subsequent sessions. CONCLUSION Foam polidocanol therapy for LFVM of tongue is cost-effective, less invasive and with added advantage of local anesthetic effect.
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Affiliation(s)
| | | | - Amit Kumar
- Department of Dentistry, AIIMS, Patna, Bihar, India
| | | | - Sumit Singh
- Department of Dentistry, AIIMS, Patna, Bihar, India
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Maymone MB, Greer RO, Burdine LK, Dao-Cheng A, Venkatesh S, Sahitya PC, Maymone AC, Kesecker J, Vashi NA. Benign oral mucosal lesions: Clinical and pathological findings. J Am Acad Dermatol 2019; 81:43-56. [DOI: 10.1016/j.jaad.2018.09.061] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023]
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