Comprehensive treatment of arteriovenous malformations in the oral and maxillofacial region.
OBJECTIVE
Arteriovenous malformations (AVMs) in the oral and maxillofacial region are rare but potentially life-threatening vascular lesions. We report our experience in treating these lesions in the oral and maxillofacial region.


METHODS
Superselective intra-arterial embolization (SIAE), sclerotherapy, bone wax packing of bone cavity and curettage, radiotherapy, and surgical resection were used alone or in combination in 28 patients with AVMs in the oral and maxillofacial region. Among them there are 13 cases involving the soft tissue, 11 cases involving bone, and 4 cases involving both the soft tissue and bone.


RESULTS
Follow-up ranged from 3 to 60 months (median, 22 months) after comprehensive treatment. The rates of improvement and cure were 89.3% and 60.7%, respectively. Sclerotherapy in 6 cases of AVMs was ineffective. The rates of improvement and cure in AVMs involving soft tissue treated by surgical resection were 23.1% and 84.6%, respectively. The rates of cure for AVMs involving the jaws treated by SIAE, bone wax packing, curettage, and partial bone resection alone or in combination was 100%.


CONCLUSIONS
Three cases of AVMs involving both soft tissue and bone treated with SIAE and radiotherapy as well as surgical resection were cured. SIAE was an adjunctive treatment for the AVMs of soft tissue and jaws and for controlling bleeding. Surgical resection was an important treatment modality for AVMs. Bone wax packing of bone cavity and curettage was a simple, safe, and effective method for the treatment of AVMs of the jaws. Radiotherapy and sclerotherapy may not be effective methods for AVMs involving the soft tissue.
Chen
Weiliang
W
Department of Oral and Maxillofacial Surgery, the Second Affiliated Hospital of Sun Yat-sen University, 107 Yanjiang Road, Guangzhou 510-120, China. drchen@vip.163.com
Wang
Jianguang
J
Li
Jinsong
J
Xu
Linfeng
L
D000293:Adolescent; D000328:Adult; D001165:Arteriovenous Malformations / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002648:Child; D003475:Curettage; D004338:Drug Combinations; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007568:Jaw / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000098:blood supply*; D010168:Palmitates / Q000627:therapeutic use; D015911:Sclerotherapy; D014885:Waxes / Q000627:therapeutic use
D004338:Drug Combinations; D006490:Hemostatics; D010168:Palmitates; D014885:Waxes; C055480:bone wax