Motamedi M H, Behnia H, Motamedi M R
Department of Oral and Maxillofacial Surgery, Trauma Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran.
J Craniomaxillofac Surg. 2000 Aug;28(4):238-42. doi: 10.1054/jcms.2000.0139.
The high-flow intraosseous arteriovenous malformation is a problematic vascular lesion which may affect bone and the dentition. Variable clinical presentations of this anomaly have resulted in a gamut of treatment modalities being reported ranging from simple curettage, resection, radiotherapy, sclerosing injections, and various forms of embolization, to immediate replantation of the resected segments. Embolization techniques alone have not been universally successful and have often resulted in rapid development of collaterals from surrounding vessels. Definitive treatment has usually involved complete surgical resection (when feasible) either alone, or in combination with other modalities such as embolization. Jaw resection, however, is deforming and leaves a defect often requiring subsequent reconstruction of the hard and soft tissues and replacement of any teeth lost with the resected segment. We report a surgical technique to treat mandibular arteriovenous malformations, which permits ligation of the feeding vessels and provides access allowing for complete removal of the intraosseous lesion. At the same time it not only prevents facial deformity by preserving the mandibular bone and oral soft tissue, but also, and more importantly, may preserve the dentition as well.
高流量骨内动静脉畸形是一种有问题的血管病变，可能会影响骨骼和牙列。这种异常的临床表现多种多样，导致报道了一系列治疗方法，从简单的刮除术、切除术、放射治疗、硬化剂注射、各种形式的栓塞，到切除节段的立即再植。仅栓塞技术并非普遍成功，且常常导致周围血管迅速形成侧支循环。确定性治疗通常涉及单独（可行时）或与其他方式（如栓塞）联合进行完全手术切除。然而，颌骨切除术会导致畸形，并留下缺损，通常需要随后进行软硬组织重建以及替换因切除节段而缺失的任何牙齿。我们报告一种治疗下颌动静脉畸形的手术技术，该技术允许结扎供血血管，并提供进入途径以便完全切除骨内病变。同时，它不仅通过保留下颌骨和口腔软组织防止面部畸形，更重要的是，还可能保留牙列。
