Surgical treatment for venous malformation

Steiner, Frederica; FitzJohn, Trevor; Tan, Swee T.

doi:10.1016/j.bjps.2013.07.033

Cited by 46 publications

(59 citation statements)

References 17 publications

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“…It may suddenly expand in response to hormonal changes or trauma (6). It may present later in life (6) with pain, swelling, ulceration, loss of function, and deformity (6, 7).…”

Section: Introductionmentioning

confidence: 99%

“…It may suddenly expand in response to hormonal changes or trauma (6). It may present later in life (6) with pain, swelling, ulceration, loss of function, and deformity (6, 7). Symptoms specific to orbital and/or periorbital VM include reduced visual acuity, diplopia, globe dystopia, and distensibility, where the lesion increases in size on head dependency or Valsalva maneuver (8, 9).…”

Section: Introductionmentioning

confidence: 99%

“…Deficiency of smooth muscle cells and elastic tissue within the walls of the affected veins leads to sequential “blowout” of the channels as the walls become progressively thinner (6). Venous stasis within these channels leads to thrombosis and subsequent thrombophlebitis.…”

Section: Introductionmentioning

confidence: 99%

“…Venous stasis within these channels leads to thrombosis and subsequent thrombophlebitis. Dystrophic calcification within the thrombus results in the formation of phleboliths (6, 12). …”

Section: Introductionmentioning

confidence: 99%

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Management of Orbital and Periorbital Venous Malformation

et al. 2017

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BackgroundTo review our management of common venous malformation (VM) affecting the orbit and/or periorbital area.MethodsConsecutive patients with orbital and/or periorbital VM were identified from our vascular anomalies database. Demographic details of the patients, anatomic site(s) affected, symptoms and signs, presence of a family history of VM, and types of treatment(s) were collected, supplemented by chart review.ResultsA total of 24 patients’ age 1–68 (mean, 30) years with orbital and/or periorbital VM presented with cosmetic concerns (n = 17, 71%), distensibility (n = 15, 63%), pain (n = 9, 38%), diplopia (n = 4, 17%), and spontaneous thrombosis (n = 1, 8%). The VM caused globe dystopia (n = 13, 54%), enophthalmos (n = 6, 25%), proptosis (n = 3, 12%), exotropia (n = 3, 12%), and pseudoptosis with visual obstruction (n = 3, 13%). A total of 11 (46%) patients were managed conservatively. 13 (54%) patients underwent active treatment. Ethanol sclerotherapy (ES) was performed in six patients with extensive facial VM associated with orbital/periorbital involvement, resulting in symptomatic improvement in five patients, one of whom developed skin necrosis and another patient developed reduced infraorbital nerve sensation. Surgery was performed for localized lesion (n = 3, 23%), for extensive lesions (n = 4, 31%) and as an adjunct to ES (n = 6, 46%) resulting in symptomatic improvement in all patients. One patient required correction of lower lid ectropion.ConclusionOrbital and/or periorbital VMs are heterogeneous, and management needs to be individualized. Surgery is used for localized lesions aiming for complete excision, as a debulking procedure for extensive orbital/periorbital VM when ES was not possible, or following ES for extensive facial VM with orbital and/or periorbital involvement.

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“…It may suddenly expand in response to hormonal changes or trauma (6). It may present later in life (6) with pain, swelling, ulceration, loss of function, and deformity (6, 7).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Venous stasis within these channels leads to thrombosis and subsequent thrombophlebitis. Dystrophic calcification within the thrombus results in the formation of phleboliths (6, 12). …”

Section: Introductionmentioning

confidence: 99%

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Management of Orbital and Periorbital Venous Malformation

et al. 2017

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“…Before the development of sclerotherapy, surgery was virtually the only treatment modality for VMs. Surgery remains the primary or an adjuvant option for some lesions, but diffuse VMs remain inoperable [5,[10][11][12][13]. Laser therapy can serve for some lesions [14,15].…”

Section: Introductionmentioning

confidence: 99%

Complications of sclerotherapy for 75 head and neck venous malformations

Castrén

Aronniemi

Klockars

et al. 2015

Eur Arch Otorhinolaryngol

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Sclerotherapy is one treatment option for head and neck venous malformations (VMs). Evaluation of complication risks is, however, essential to improve its safety. We aimed to systematically report sclerotherapy complications by means of the Clavien-Dindo classification and to distinguish factors predisposing to complications. We identified our institution's head and neck VM patients who received sclerotherapy between 1 January 2007 and 31 August 2013, analyzed patient reports retrospectively, and applied to them the Clavien-Dindo classification. Our 75 VM patients underwent a total of 150 sclerotherapy sessions. The most common sclerosants were 3 % sodium tetradecyl sulfate and polidocanol. Complications occurred in 13 patients (17.3 %) and in 15 sessions (10.0 %); 3 complications required extensive postprocedural treatment and caused permanent morbidity, whereas 12 received conservative treatment. Patients with sclerotherapy complications underwent more treatments (p = 0.009) and more often needed further surgery (p = 0.007). We thus consider sclerotherapy a relatively safe treatment modality for head and neck VMs. To avoid complications, evaluation of VM characteristics and optimal treatment technique in a multidisciplinary team is vital.

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Contemporary Management of Vascular Anomalies of the Head and Neck—Part 1: Vascular Malformations

Gallant

Chewning

Orbach

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Vascular anomalies of the head and neck are relatively rare lesions. Management is challenging because of the high likelihood of involvement of functionally critical structures. Multiple modalities of treatment exist for vascular anomalies of the head and neck, including medical therapies, sclerotherapy and embolization procedures, and surgery. This review focuses on the accurate diagnosis and the relative roles of the various therapeutic options.OBSERVATIONS Vascular anomalies are classified by the International Society for the Study of Vascular Anomalies into 2 major groups: vascular tumors and vascular malformations. Vascular tumors encompass proliferative lesions ranging from infantile and congenital hemangiomas to kaposiform hemangioendothelioma. Alternatively, vascular malformations are embryologic errors in vasculogenesis. This article focuses on the management of vascular malformations. The 3 primary vascular malformation subclassifications are lymphatic, venous, and arteriovenous. The burden of disease, diagnosis, and current management options are discussed in detail for each subtype.CONCLUSIONS AND RELEVANCE Most vascular malformations of the head and neck require a multidisciplinary approach. Available medical, interventional radiologic, and surgical interventions are constantly evolving. Optimization of function and cosmesis must be balanced with minimization of treatment-associated morbidity. Otolaryngologists-head and neck surgeons must remain up to date regarding options for diagnosis and management of these lesions.

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Surgical treatment for venous malformation

Cited by 46 publications

References 17 publications

Management of Orbital and Periorbital Venous Malformation

Management of Orbital and Periorbital Venous Malformation

Complications of sclerotherapy for 75 head and neck venous malformations

Contemporary Management of Vascular Anomalies of the Head and Neck—Part 1: Vascular Malformations

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