Hassmann-Poznańska Elibieta, Kurzyna Agnieszka
Klinika Otolaryngologii Dzieciecej AM w Białymstoku.
Otolaryngol Pol. 2006;60(5):663-74.
This paper presents the review of current knowledge regarding vascular lesions of the head and neck. For many years the term hemangioma was used to describe all vascular lesions. Mulliken and Glowacki classified congenital vascular lesions and recognized two distinct entities, hemangiomas-vascular tumors and vascular malformations. Hemangiomas are usually not present at birth, proliferate during first year of life and then involute. They are composed of proliferating endothelial cells. Vascular malformations are always present at birth although not always apparent, increase slowly in size throughout whole life and never involute. They enlarge by hypertrophy of malformed vessels. Vascular malformations can be further subdivided according to the type of involved vessels as arterial, arteriovenous, venous, capillary or lymphatic. Accurate diagnosis of hemangiomas and vascular malformations remains a challenge for physicians. Although majority of hemangiomas are self limiting lesions some of them may develop complications such as; ulceration, airway obstruction, ophthalmic complications, psychosocial consequences. Segmental hemangiomas are associated with the risk of structural anomalies such as those that occur in PHACE syndrome. Clinical presentation and forms of treatment of various forms of vascular malformations are presented. Vascular malformations have to be treated according to their histopathology and location, as well as their hemodynamic features shown by radiological examinations.
本文对目前有关头颈部血管病变的知识进行了综述。多年来,“血管瘤”一词被用于描述所有血管病变。穆利肯和格沃茨基对先天性血管病变进行了分类,并识别出两种不同的类型,即血管瘤(血管肿瘤)和血管畸形。血管瘤通常在出生时并不存在,在出生后的第一年增殖,然后消退。它们由增殖的内皮细胞组成。血管畸形在出生时总是存在,尽管并非总是显而易见,其大小在一生中缓慢增加,且从不消退。它们通过畸形血管的肥大而增大。血管畸形可根据受累血管的类型进一步细分为动脉性、动静脉性、静脉性、毛细血管性或淋巴管性。对血管瘤和血管畸形进行准确诊断仍然是医生面临的一项挑战。尽管大多数血管瘤是自限性病变,但其中一些可能会出现并发症,如溃疡、气道阻塞、眼部并发症、心理社会后果。节段性血管瘤与诸如PHACE综合征中出现的结构异常风险相关。本文还介绍了各种形式血管畸形的临床表现和治疗方式。血管畸形必须根据其组织病理学、位置以及放射学检查显示的血流动力学特征进行治疗。