Treatment for extracranial arteriovenous malformations of the head and neck.
CONCLUSIONS
For extracranial arteriovenous malformations of the head and neck (HNAVMs), in which the nidus was accessible via the percutaneous route, ethanol sclerotherapy was a feasible and safe first-line treatment, although successful outcomes were obtained for only about half of the subjects. For other HNAVMs, surgical excision with embolization may be the best choice of treatment.


OBJECTIVE
To suggest a treatment protocol for patients with HNAVMs by comparing the treatment outcomes and complications of ethanol sclerotherapy with those of surgical excision combined with embolization.


METHODS
Twenty patients who had been diagnosed with HNAVM and treated between 1995 and 2002 were retrospectively reviewed. Ethanol sclerotherapy, surgical excision and embolization were used as treatments, either alone or in various combinations. The treatment outcomes and complications with the different modalities were analyzed.


RESULTS
Ethanol sclerotherapy was used for 12 cases, with a success rate of 50.0% and a permanent complication rate of 8.3%. Surgical excision combined with embolization was used for 13 patients. Although all patients achieved successful resolution of their HNAVM after surgical excision, 15.4% suffered from permanent complications. In total, 16/20 patients (80.0%) eventually achieved a > or = 75% reduction in the size of their lesions.
Jeong
Han-Sin
HS
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Baek
Chung-Hwan
CH
Son
Young-Ik
YI
Kim
Tae Wook
TW
Lee
Byoung Bung
BB
Byun
Hong Sik
HS
D000293:Adolescent; D000328:Adult; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D002648:Child; D004621:Embolization, Therapeutic; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006257:Head; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D018570:Risk Assessment; D015911:Sclerotherapy / Q000379:methods; D015996:Survival Rate; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods
D000431:Ethanol