Multidisciplinary Approach in the Management of Head and Neck Vascular MalformationsLudovica Marcella Ponzo*, Giovanni Dell’Aversana Orabona, Giorgio Iaconetta, Fabio Astarita, Giuseppe Leone, Renato Cuocolo, Lorenzo Ugga, Francesco Briganti and Luigi Califano
AICEF - ORL Italian Association of Cosmetic Surgery Facial and Neck Functional Rino, Italy
- *Corresponding Author:
- Ludovica Marcella Ponzo
AICEF - ORL Italian Association of Cosmetic
Surgery Facial and Neck Functional Rino, Italy
E-mail: [email protected]
Received Date: May 18, 2017; Accepted Date: June 02, 2017; Published Date: June 09, 2017
Citation: Ponzo LM, Orabona GDA, Iaconetta G, Astarita F, Leone G, et al. (2017) Multidisciplinary Approach in the Management of Head and Neck Vascular Malformations. J Vasc Med Surg 5: 316. doi: 10.4172/2329-6925.1000316
Copyright: © 2017 Ponzo LM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purpose: Arteriovenous malformations (AVM) of the head and neck are rare anomalies, but often present with significant haemorrhage or cosmetic defects. The purpose of this study is to determine the effectiveness of embolization of each type of vascular malformation. Methods: A retrospective review was performed between January 2009 to June 2015 on 36 patients who were diagnosed vascular malformations in the head and neck regions and were referred to our department for transarterial or percutaneous embolization before the surgical approach. Results: All 26 AVM were embolized with a transarterial approach: 18 with Onyx, 8 with a combination of PVA and coils. All patients with an AVM had a single endovascular approach. All 10 venous-lymphatic malformations were treated with a percutaneous sclerotherapy with ethanol injection. Complete healing was obtained in 30 patients (83%). In 6 (17%) there was a recurrence with necessity of a retreatment, 4 at 6 months, 2 at 12 months. Conclusion: Transarterial embolization and percutaneous scleroterapy is a safe treatment for artero-venous malformations before the surgical treatment. A multidisciplinary approach is fundamental to reduce the bleeding risks, the time of the surgical intervention and favouring a lesser demolitive approach particularly in large vascular malformations. Surgical complications occurred in 6 patients (17%); all of them developed infections of the surgical wounds; 3 of these developed necrosis of the skin flap used for the reconstruction with subsequent dehiscence. No other complications including sepsis, hemorrhages, cranial nerve palsies or neuropathies occurred.