title: Therapeutic choice for craniofacial venous malformations.
abstract: Even though the precise mechanisms related to venous malformation are still unclear, the clinical manifestations sometimes threaten vital signs such as mastication, airway and phonics. Our therapeutic modalities were reviewed, and their effectiveness and related complications were analyzed. Between March, 1998 and February, 2006, 11 patients (15-59 years old; average 32.4 +/- 13.60, 4 women and 7 men) with craniofacial venous malformation were included in this investigation. All cases experienced some kind of surgery at least once during clinical follow-up. Direct puncture scintigraphy with technetium-99m Sn colloid-labeled demonstrated low-flow malformations in all cases. Two cases underwent bone surgery and another two cases had static suspensions for facial nerve paralysis. Blood loss from surgery alone was 1352 +/- 1115.0 mL, simultaneous procedures yielded 400 +/- 244.9 mL blood loss and sclerotherapy alone resulted in 187 +/- 284.8 mL of blood loss (surgery alone versus sclerotherapy alone, P < 0.01). Excellent sclerotherapy cases were when the malformation was localized and the number of sclerotherapies was significantly fewer than good cases (1.3 +/- 0.58 times versus 3.6 +/- 1.15 times, excellent, good, respectively, P < 0.05). Although there are difficulties in understanding the mechanisms and multiple therapeutic interventions are required, there have been satisfactory outcomes so far and the development of better sclerosants or a real-time navigation system may benefit more precise therapeutic effects and lower morbidity.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Nagasaki University, Graduate School of Biomedical and Sciences, 1-7-1 Sakamoto-machi, Nagasaki 8528501, Japan. akitas@hf.rim.or.jp
authors.forename: Sadanori
authors.initials: S
authors.lastname: Akita
authors.forename: Kozo
authors.initials: K
authors.lastname: Akino
authors.forename: Katsumi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Anraku
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yano
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Hirano
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D002610:Cheek / Q000098:blood supply; D005145:Face / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000098:blood supply; D009333:Neck / Q000098:blood supply; D011183:Postoperative Complications; D019275:Radiopharmaceuticals; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy; D012886:Skull / Q000098:blood supply*; D017556:Technetium Compounds; D017971:Tin Compounds; D016896:Treatment Outcome; D014680:Veins / Q000002:abnormalities* / Q000601:surgery
chemical_list: D019275:Radiopharmaceuticals; D012597:Sclerosing Solutions; D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid