[Arteriovenous malformations of the head and neck. Diagnosis and methods of treatment].

BACKGROUND

After a review of the literature, the results of a clinical study carried out on cases of extracranial arteriovenous malformations of the head and neck, are reported.

METHODS

Thirteen patients with extracranial arteriovenous malformations of the head and neck have been treated at the Maxillofacial Department of the University of Parma from 1995 to 2000. Five patients observed the onset in childhood, five in adolescence and three in adulthood. Arteriovenous malformations have been classified according to Schobinger's clinical staging. Four patients with superselective embolization, one with surgical resection and the remaining eight with superselective embolization followed by radical en bloc resection have been treated. The follow-up period varied from 2 to 5 years.

RESULTS

No relapses have been observed in the cases treated with surgical resection and with superselective embolization followed by radical excision. Only 1 patient treated by superselective embolization had a good outcome. This treatment can be a good palliative in the treatment pain and bleeding particularly when surgical excision would result in mutilation or disfigurement, nevertheless it is necessary a careful follow-up since the lesion treated only by superselective embolization can grow quickly and begin bleeding and aching again.

CONCLUSIONS

In personal experience, according to the literature, embolic/surgical management of arteriovenous malformations is not always the treatment of choice. On the basis of clinical characteristics of the lesions, different kinds of treatments (embolization, resection, embolization followed by resection) may be chosen to obtain favorable RESULTS.