SIO         

Loading

Intra-operative sclerotherapy for treatment of a head and neck venous malformation

Trattamento di una malformazione venosa del distretto testa-collo mediante scleroterapia intraoperatoria

K. Kourelis1, P. Johnson2, D. Girod1

1 Kansas University Medical Center, Department of Otolaryngology, Kansas City, KS, USA; 2 Kansas University Medical Center, Department of Radiology, Kansas City, KS, USA

FULL TEXT - PDF DOCUMENT

Summary

Venous malformations of the head and neck are congenital lesions that grow steadily without spontaneous regression. We describe the management of a 47-year-old woman with an extensive subcutaneous venous malformation of bilateral submandibular regions and the entire tongue, refractory to multiple surgical excisions and percutaneous sclerotherapy sessions. The tumour lacked prominent feeding arteries for embolisation, but maintained high blood outflow via a few substantial venous branches. Sclerotherapy to the lesion was prevented by major communicating branches from the mass to the internal jugular vein bilaterally. Our approach entailed direct surgical access to the malformation, ligation of these communicating veins and intraoperative sclerotherapy with ethanol injection into the vessel stumps.

Riassunto

Le malformazioni venose della testa e del collo sono lesioni congenite che crescono costantemente, senza regressione spontanea. Presentiamo il caso clinico di una donna di 47 anni con una estesa malformazione venosa sottocutanea delle regioni sottomandibolari e della lingua refrattaria a più escissioni chirurgiche ed a sedute di scleroterapia percutanea. Il nostro approccio ha permesso un accesso chirurgico diretto alla malformazione, la legatura delle vene comunicanti, e la scleroterapia intraoperatoria con iniezione di etanolo.