title: Preoperative sclerotherapy of facial venous malformations: impact on surgical parameters and long-term follow-up.
abstract: OBJECTIVE
  To analyze the operative benefit of preoperative sclerotherapy of facial venous malformations and assess long-term patient outcome.
  
  
  METHODS
  Preoperative sclerotherapy was performed in 24 consecutive patients referred before resection of facial venous malformation. Pretreatment imaging was reviewed for malformation dimensions (length, width, and height), and volumes were estimated. Sclerotherapy was performed with 3% sodium tetradecyl in the first 15 patients and 98% dehydrated alcohol in the remaining 9 patients. Operative blood loss, operative time, transfusion requirement, and hospital stay were recorded. Operative time per lesion volume and operative blood loss per lesion volume were calculated. Results were compared with 15 historical control patients who underwent resection of facial venous malformations without preoperative sclerotherapy. Long-term follow-up of study and control patients was performed.
  
  
  RESULTS
  Compared with controls, patients undergoing preoperative venous sclerotherapy were significantly older (P = .0206) and had larger lesions in all three dimensions (height, P = .0002; length, P = .0010; width, P = .0004). Patients receiving sclerotherapy had shorter operative time per lesion volume (P < .0001) and reduced blood loss per lesion volume (P < .0001). Neither hospital stay nor the need for blood transfusion differed from the control patients (P = .2449 and P = .6857). Mild periprocedural complications were encountered in 12.5% of cases, and nerve paresis occurred in 8.3% of cases. Long-term follow-up revealed retreatment was required in 2 of 24 patients (8.3%).
  
  
  CONCLUSIONS
  Preoperative sclerotherapy of venous malformations was associated with less operative time per lesion volume and less operative blood loss per lesion volume. Long-term follow-up revealed a low need for retreatment.
authors.affiliation: Department of Radiology, 4301 West Markham, Slot #556, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. jamescharlesa@uams.edu
authors.forename: Charles A
authors.initials: CA
authors.lastname: James
authors.forename: Leah E
authors.initials: LE
authors.lastname: Braswell
authors.forename: Lonnie B
authors.initials: LB
authors.lastname: Wright
authors.forename: Paula K
authors.initials: PK
authors.lastname: Roberson
authors.forename: Mary B
authors.initials: MB
authors.lastname: Moore
authors.forename: Milton
authors.initials: M
authors.lastname: Waner
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Buckmiller
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D015911:Sclerotherapy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D014680:Veins / Q000002:abnormalities / Q000601:surgery; D055815:Young Adult