The use of foam sclerotherapy for the treatment of head and neck vascular malformations.

Oral and Maxillofacial Surgery, University Hospital Birmingham, Birmingham, United Kingdom.
British Journal of Oral and Maxillofacial Surgery (Impact Factor: 1.13). 05/2009; 47(8):631-2. DOI: 10.1016/j.bjoms.2009.03.007
Source: PubMed
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    ABSTRACT: Absolute ethanol sclerotherapy provides a reliable treatment for facial venous malformation, although facial nerve injury may occur after sclerotherapy. This study is a retrospective review of facial nerve dysfunction after sclerotherapy. A total of 91 patients with facial venous malformations accepted 288 ethanol sclerotherapy sessions. The facial nerve dysfunctions caused by the therapy were evaluated and analyzed. There were 9 instances of facial nerve injury. For 18 sessions of sclerotherapy in the temporal region, 5.6% of patients experienced injury to the temporal branch; for 12 sessions in the zygomatic region, 41.7% of patients experienced injury to the zygomatic branch. After patients were treated with medication, 8 of 9 instances of nerve injury recovered. The zygomatic and temporal branches of the facial nerve were the most vulnerable to injury after ethanol sclerotherapy. Surgeons are thus called on to pay more attention when performing ethanol sclerotherapy in those areas.
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    ABSTRACT: We have reviewed our experience (15 patients during the period 2008-2012) in the treatment of low flow vascular malformations (LFVMs) of the face and oral cavity with polidocanol foam sclerotherapy. They were diagnosed clinically and with the help of Doppler ultrasound and magnetic resonance imaging. The maximum dose recommended for each session was 20mg/day and the minimum interval between sessions was 4 weeks. Embolisation was repeated as many times as needed until the size of the lesions and the symptoms had been reduced sufficiently. Patients were followed up 1, 6, and 12 months after treatment had finished, and the size of the lesions was assessed objectively. The 8 men and 7 women were aged between 18 and 71 (mean 44) years. The lesions had reduced and symptoms had improved in all cases. During the follow-up period, one patient relapsed and developed further symptoms. The pain and postoperative inflammation were successfully controlled with an analgesic and an anti-inflammatory drug. There was only one complication (superficial necrosis), which healed completely by second intention. Direct puncture and sclerosis with polidocanol foam are an effective treatment for LFVM of the face and oral cavity.
    British Journal of Oral and Maxillofacial Surgery 05/2013; · 1.13 Impact Factor
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    ABSTRACT: The aim of this pilot study is to evaluate office-based sclerotherapy using sodium tetradecyl sulfate (STS) for epistaxis due to hereditary hemorrhagic telangiectasias (HHT). Patients with HHT suffer from unpredictable, recurrent, severe nasal bleeding necessitating emergency care, nasal packing, blood transfusions, and invasive procedures. In this retrospective study 7 patients with a history of treatment for recurrent epistaxis due to HHT were treated in an office-based setting with intralesional injection of STS. Treatment results were evaluated using a questionnaire. All patients had undergone multiple prior procedures attempting to control epistaxis. Patients had an average of 5 sclerotherapy treatments for HHT. Patients were treated using topical and/or local anesthesia with no reports of discomfort. Bleeding requiring intervention did not occur during the procedures. After the procedure all patients (100%) reported significantly less frequent and less severe nasal bleeding. A total of 83% reported that their need for nasal packing was reduced. All patients were willing to undergo the same treatment again. No complications such as perforation, crusting, or foul smell were reported. This is the first clinical experience demonstrating that office-based sclerotherapy with STS is a safe, tolerable, and useful alternative for the treatment of epistaxis due to HHT.
    International Forum of Allergy and Rhinology 07/2011; 1(4):319-23. · 1.00 Impact Factor