Percutaneous Treatment of Large Venous Malformations in the Oral and Maxillofacial Regions Using Electrochemical Therapy Combined With Pingyangmycin.
OBJECTIVE
The aim of the present study was to evaluate the therapeutic outcome of using electrochemical therapy (ECT) combined with a sclerosing agent, pingyangmycin (bleomycin A5 hydrochloride; PYM), for large (>3 cm in diameter) venous malformations (VMs) in the oral and maxillofacial regions.


METHODS
Thirty-five patients (15 male and 20 female; age range, 10 to 69 yr; mean age, 32 yr) with large VMs in the oral and maxillofacial region were treated with a combination of ECT and PYM under general anesthesia in the authors' department from June 2012 through May 2014. The size of the lesions varied from 3 × 3 to 12 × 15 cm. A repeated course of ECT and PYM was administered for larger VMs. The therapeutic interval was 3 months for ECT and 2 to 4 weeks for PYM. The dose of PYM for patients was 8 mg each time, and the injection concentration of PYM was 1.6 mg/mL. Patients were followed for 6 to 36 months. Therapeutic results were evaluated by clinical examination and Doppler ultrasonography before and after treatment.


RESULTS
Of the 35 patients, 29 (82.9%) received 1 ECT treatment, 5 (14.3%) received 2 ECT treatments, and 1 (2.8%) received 3 ECT treatments. The number of PYM injection sessions was 1 to 5 (average, 2.5 times). According to the therapeutic criteria, the clinical outcome was excellent in 22 patients (62.9%), good in 10 patients (28.6%), and fair in 3 patients (8.5%). All patients (100%) had local swelling postoperatively that lasted approximately 1 to 2 weeks. Two patients (5.7%) had fever. No skin necrosis or nerve damage was found.


CONCLUSIONS
Percutaneous treatment using ECT and PYM was a straightforward, safe, and reliable treatment modality for large VMs.
Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
Lei
L
Xue
Resident, Department of Endodontics, School of Stomatology, Shandong University, Jinan, China.
Rong-Yu
RY
Cao
Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
Da-Peng
DP
Xu
Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
Ning-Ning
NN
Sun
Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
Hai-Song
HS
Tan
Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China. Electronic address: wangxukai757892@sina.com.
Xu-Kai
XK
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D001165:Arteriovenous Malformations / Q000188:drug therapy*; D001761:Bleomycin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002610:Cheek / Q000098:blood supply; D002648:Child; D053672:Electrochemotherapy / Q000379:methods*; D005145:Face / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008046:Lip / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000098:blood supply*; D009333:Neck / Q000098:blood supply; D010159:Palate / Q000098:blood supply; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D014059:Tongue / Q000098:blood supply; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D055815:Young Adult
D000903:Antibiotics, Antineoplastic; D012597:Sclerosing Solutions; D001761:Bleomycin; C025703:bleomycetin