Single-stage excision of localized head and neck venous malformations using preoperative glue embolization.
OBJECTIVE
Describe single-stage removal of head and neck venous malformations using percutaneous embolization with n-butyl cyanoacrylate (n-BCA) glue prior to surgical resection.


METHODS
Case series with chart review.


METHODS
Tertiary-care pediatric hospital.


RESULTS
A total of 169 venous malformations were identified between 2000 and 2012, and 102 (60.1%) were in the head and neck. Thirty-five of 102 (34.3%) were observed, 56 of 102 (54.9%) had invasive therapy, and 11 of 102 (10.8%) underwent n-BCA embolization and surgery ("GES procedure"). The median age of the glue embolization and surgery cohort was 14 years (range, 6-19), and 7 of 11 (63.6%) were female. Treated venous malformations involved the oral cavity/tongue (4/11; 36.4%) and parotid/face (7/11; 63.6%). During facial lesion excision, intraoperative facial nerve monitoring was used. All surgical sites (11/11) were closed primarily. No patient in this cohort had any posttreatment nerve deficits, dysarthria, and dysphagia or lesion persistence.


CONCLUSIONS
Localized venous malformations can be treated with preoperative percutaneous embolization with n-BCA glue followed by surgical excision. This technique, with selective motor nerve monitoring, appears safe and allows for complete venous malformation removal with limited nerve dissection, to allow maximal tissue and functional preservation.
Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA.
David D
DD
Tieu
Basavaraj V
BV
Ghodke
Nghia J
NJ
Vo
Jonathan A
JA
Perkins
D000293:Adolescent; D002648:Child; D004621:Embolization, Therapeutic; D004659:Enbucrilate / Q000008:administration & dosage*; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D011300:Preoperative Care; D014014:Tissue Adhesives / Q000008:administration & dosage*; D054079:Vascular Malformations / Q000601:surgery / Q000628:therapy*; D014680:Veins / Q000002:abnormalities*; D055815:Young Adult
D014014:Tissue Adhesives; D004659:Enbucrilate