Surgical treatment of vascular malformations of the facial bones.
OBJECTIVE
To characterize intraosseous vascular malformations and describe the most appropriate approach for treatment according to clinical experience and a review of the published data.


METHODS
We performed a retrospective review of 11 vascular malformations (7 venous and 4 arteriovenous) of the facial bones treated during a 10-year period using en bloc resection or intraoral aggressive curettage alone or preceded by endovascular embolization. Corrective surgery was planned to address any residual bone deformities. The cases were reviewed at a mean follow-up point of 6 years.


RESULTS
Facial symmetry was restored in the cases requiring reconstruction. Tooth sparing was possible in the case of jaw and/or maxillary localization. Recanalization occurred in 14% of the venous and 33% of the arteriovenous malformations.


CONCLUSIONS
Facial intraosseous venous malformations can be successfully treated using surgery alone. Facial intraosseous arteriovenous malformations will be better addressed using combined approaches. Aggressive curettage will obviate the need for extensive surgical resection in selected cases.
Attending Surgeon, Division of Maxillo-Facial Surgery, Department of Biomedical, Surgical, and Dental Sciences, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy. Electronic address: giacomo.colletti@gmail.com.
Giacomo
G
Colletti
Research Fellow, Carolyn and Peter Lynch Center for Laser and Reconstructive Surgery, Division of Facial Plastic and Reconstructive Surgery, Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA.
Alice
A
Frigerio
Resident, Division of Maxillo-Facial Surgery, Department of Biomedical, Surgical, and Dental Sciences, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy.
Federica
F
Giovanditto
Associate Professor, Division of Maxillo-Facial Surgery, Department of Biomedical, Surgical, and Dental Sciences, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy.
Federico
F
Biglioli
Professor, Division of Oral Surgery, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy.
Matteo
M
Chiapasco
Director of Vascular Anomalies Center, Division of Otolaryngology, Department of Surgery, Primary Children's Medical Center, University of Utah, Salt Lake City, UT.
J Fredrik
JF
Grimmer
D001165:Arteriovenous Malformations / Q000601:surgery*; D002648:Child; D005147:Facial Bones / Q000098:blood supply*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures; D014680:Veins / Q000002:abnormalities* / Q000601:surgery