Surgical management of large venous malformations of the lower face

Hontanilla, Bernardo; Qiu, Shanshan; Marré, Diego

doi:10.1016/j.bjoms.2013.06.008

Cited by 13 publications

(13 citation statements)

References 20 publications

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“…Other treatment methods for VMs include cryotherapy, laser surgery (Nd:YAG or KTP), vascular ligation, and corticosteroids. 5,10 While infiltrative transspatial VMs are difficult to treat, localized lesions can be generally be treated with surgical excision. Local recurrence is often due to incomplete surgical resection and is more common with diffuse malformations.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Unilateral Swelling of the Parotid Gland

Haidar

Tjoa

Goddard

2017

JAMA Otolaryngol Head Neck Surg

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A 45-year-old woman initially presented for evaluation of a 6-month history of intermittent left facial swelling and pain. She noted a discretely palpable mass in the left parotid region during these episodes. However, at the time of clinic presentation, she had no palpable masses on physical examination. Ultrasonography performed on the day of initial evaluation revealed no intraparotid masses, lesions, or stones. The patient was encouraged to return if she noticed acute return of swelling so that she could be evaluated when symptomatic. The patient returned days later with acutely worsening left facial swelling, which she noticed while straining. On presentation, she was diagnosed as having malignant hypertension and had a palpable parotid lesion noted on physical examination. When asked to perform a Valsalva maneuver, she was noted to have more pronounced left facial swelling (Figure , A). A short tau inversion recovery (STIR) image is shown in the Figure, B. Magnetic resonance angiogram was obtained (Figure, C and D).

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Section: Discussionmentioning

confidence: 99%

Recurrent Unilateral Swelling of the Parotid Gland

Haidar

Tjoa

Goddard

2017

JAMA Otolaryngol Head Neck Surg

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“…The basic information of enrolled patients is indicated in Table . For subsequent analysis, we divided the patients with VM into two subgroups depending on the size of the lesions according to a previous study (Hontanilla et al , ). Lesion measurements were taken along the greatest axis of the lesions: type I VM (VM‐I) were measured as <3 cm while lesions ≥3 cm, or VM with diffuse lesions were classified as type II (VM‐II).…”

Section: Methodsmentioning

confidence: 99%

Characterization of microparticles in patients with venous malformations of the head and neck

et al. 2016

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“…While other modalities can provide symptomatic improvement, persistence/recurrence is expected. 104 Similar to as has been done for LMs, multiple authors have sought to subclassify VMs to identify those that are most appropriate for surgery. 76,102,105 In a level III, casecontrol, clinical trial of 69 patients with head and neck VMs, researchers categorized lesions based not only on size but also on venography and subsequently created a management algorithm based on their findings and associated outcomes.…”

Section: Surgerymentioning

confidence: 99%

“…79 Lesions that were large (> 5 cm), diffusely infiltrating, and less surgically accessible were associated with greater morbidity and functional deficits, and required the use of multiple treatment modalities. 76 The current literature that supports surgery for the treatment of VMs is mainly in the form of level III, case-control clinical trials 75,76,106 and level IV, retrospective case series, 88,97,104,[107][108][109][110][111] without any RCTs comparing surgical management to other modalities. As treatment of VMs is rapidly becoming a multidisciplinary challenge, the majority of newer evidence that discusses surgical management of VMs does so using multimodality approaches, combining surgery with other treatment options.…”

Section: Surgerymentioning

confidence: 99%

“…75 Once unacceptably high surgical morbidities have recently been reported as low as 0 to 6% in a small, retrospective case series. 104 The low complication rate may in part be due to small sample size and selection bias of the study; however, the impact of newer multidisciplinary approaches and the aforementioned staging systems that stratify lesions based on their appropriateness for surgery are also likely contributing to improved complication rates. VMs of specific sub-sites, such as the parotid gland, are associated with increased surgical morbidity due to their proximity to important underlying structures.…”

Section: Surgerymentioning

confidence: 99%

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Evidence-Based Management of Vascular Malformations

2016

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Vascular malformations of the head and neck are complex lesions that are notoriously difficult to manage. Treatment of these lesions often requires a multispecialty and multimodal approach. In the modern era of evidence-based medicine, it has become imperative for clinicians to incorporate evidence-based treatment algorithms into their everyday practices. With general widespread inundation of the literature with levels IV and V clinical evidence, however, it is often difficult to draw meaningful conclusions that can be practically applied to the clinical question at hand. When asking how best to manage the most common vascular malformations, we are faced with this large volume of lower level studies conducted in drastically different ways without consistency in outcomes reporting, thus making direct comparison nearly impossible. Furthermore, much of the evidence shows mixed results, adding to confusion over what the optimal evidence-based treatment approaches truly are. In attempt to derive consensus from available literature discussing the management of vascular malformations, we reviewed the current literature detailing modern-day treatment approaches for lymphatic malformations, venous malformations, and arteriovenous malformations of the head and neck.

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Surgical management of large venous malformations of the lower face

Cited by 13 publications

References 20 publications

Recurrent Unilateral Swelling of the Parotid Gland

Recurrent Unilateral Swelling of the Parotid Gland

Characterization of microparticles in patients with venous malformations of the head and neck

Evidence-Based Management of Vascular Malformations

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