A multidisciplinary approach to treating maxillofacial arteriovenous malformations in children.
OBJECTIVE
Congenital arteriovenous malformations (AVMs) in the maxillofacial region are rare, potentially life-threatening, vascular lesions. This study reviewed our experience with a multidisciplinary approach to treating maxillofacial AVMs in children.


METHODS
Thirteen patients (10 boys and 3 girls) with AVMs involving the facial soft tissues or jaws were treated using a multidisciplinary approach that included: 1) superselective intra-arterial embolization (SIAE); 2) bone wax packing (BWP) of the bone cavity and curettage; and 3) compartmentalization and sclerotherapy.


RESULTS
The mean follow-up was 13.5 months, with a range of 6-22 months. The following outcomes were obtained: 9 lesions (69.2%) were completely involuted, 3 lesions (23.1%) were mostly involuted, and 1 lesion (7.7%) was partially involuted. The rates of completely and mostly involuted AVMs involving the jaws treated using SIAE, BWP, and curettage were 80% and 20%, respectively. The rates of completely, mostly, and partially involuted AVMs involving soft tissues treated by compartmentalization and sclerotherapy were 60%, 30%, and 10%, respectively.


CONCLUSIONS
SIAE was reliable for controlling bleeding and as adjunctive treatment for maxillofacial AVMs in children. SIAE followed by BWP of the bone cavity and curettage was a simple, safe, and effective method for treating AVMs of the jaws; SIAE followed by compartmentalization and the injection of OK-432 and pingyangmycin was a reliable alternative treatment for AVMs of the soft tissues in the maxillofacial region.
Chen
Wei-liang
WL
Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. drchen@vip.163.com
Ye
Jian-tao
JT
Xu
Lin-feng
LF
Huang
Zhi-quan
ZQ
Zhang
Da-ming
DM
D000293:Adolescent; D001165:Arteriovenous Malformations / Q000601:surgery / Q000628:therapy*; D001761:Bleomycin / Q000031:analogs & derivatives / Q000627:therapeutic use; D018786:Bone Substitutes / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003475:Curettage; D004338:Drug Combinations; D004621:Embolization, Therapeutic / Q000379:methods; D005145:Face / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008334:Mandible / Q000098:blood supply*; D008437:Maxilla / Q000098:blood supply; D009055:Mouth / Q000098:blood supply; D010168:Palmitates / Q000627:therapeutic use; D010844:Picibanil / Q000627:therapeutic use; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods; D016896:Treatment Outcome; D014885:Waxes / Q000627:therapeutic use
D018786:Bone Substitutes; D004338:Drug Combinations; D006490:Hemostatics; D010168:Palmitates; D012597:Sclerosing Solutions; D014885:Waxes; D001761:Bleomycin; D010844:Picibanil; C025703:bleomycetin; C055480:bone wax