Jeong Han-Sin, Baek Chung-Hwan, Son Young-Ik, Kim Tae Wook, Lee Byoung Bung, Byun Hong Sik
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Acta Otolaryngol. 2006 Mar;126(3):295-300. doi: 10.1080/00016480500388950.
For extracranial arteriovenous malformations of the head and neck (HNAVMs), in which the nidus was accessible via the percutaneous route, ethanol sclerotherapy was a feasible and safe first-line treatment, although successful outcomes were obtained for only about half of the subjects. For other HNAVMs, surgical excision with embolization may be the best choice of treatment.
To suggest a treatment protocol for patients with HNAVMs by comparing the treatment outcomes and complications of ethanol sclerotherapy with those of surgical excision combined with embolization.
Twenty patients who had been diagnosed with HNAVM and treated between 1995 and 2002 were retrospectively reviewed. Ethanol sclerotherapy, surgical excision and embolization were used as treatments, either alone or in various combinations. The treatment outcomes and complications with the different modalities were analyzed.
Ethanol sclerotherapy was used for 12 cases, with a success rate of 50.0% and a permanent complication rate of 8.3%. Surgical excision combined with embolization was used for 13 patients. Although all patients achieved successful resolution of their HNAVM after surgical excision, 15.4% suffered from permanent complications. In total, 16/20 patients (80.0%) eventually achieved a > or = 75% reduction in the size of their lesions.
对于头颈部颅外动静脉畸形（HNAVMs），若畸形团可经皮穿刺到达，则乙醇硬化疗法是一种可行且安全的一线治疗方法，尽管只有约一半的患者获得成功治疗效果。对于其他HNAVMs，手术切除联合栓塞可能是最佳治疗选择。
通过比较乙醇硬化疗法与手术切除联合栓塞的治疗效果及并发症，为HNAVMs患者推荐一种治疗方案。
回顾性分析1995年至2002年间确诊并接受治疗的20例HNAVMs患者。治疗方法包括单独或多种组合使用乙醇硬化疗法、手术切除和栓塞。分析不同治疗方式的治疗效果及并发症。
12例患者采用乙醇硬化疗法，成功率为50.0%，永久性并发症发生率为8.3%。13例患者采用手术切除联合栓塞治疗。尽管所有患者术后HNAVM均成功消除，但15.4%的患者出现永久性并发症。总体而言，20例患者中有16例（80.0%）最终病变大小缩小≥75%。
