Collin A-C, Viremouneix L, Guibaud L, Breton P
Service de chirurgie maxillofaciale, centre hospitalier Lyon-Sud, 69310 Pierre-Bénite, France.
Rev Stomatol Chir Maxillofac. 2010 Feb;111(1):11-8. doi: 10.1016/j.stomax.2009.12.001. Epub 2010 Jan 15.
Intraosseous arteriovenous maxillomandibular malformations are rare. The diagnosis is primarily clinical (children with pulsatile osseous tumefaction, bleeding at cingulum), completed with imaging techniques (TDM and/or MRI). Arteriography is indicated only at the time of therapeutic management. The evolution may vary greatly (four levels: quiescence, expansion, destruction, decompensation) and usually evolves because of hormonal changes or trauma. Radiotherapy and vascular ligatures are no longer recommended. The best treatment is direct or transarterial embolization. Surgical resection, when feasible, must be thorough. It is indicated in case of failure or recurrence after embolization.
颌骨内动静脉畸形较为罕见。诊断主要依靠临床症状(出现搏动性骨质肿胀的儿童、龈缘出血),并通过影像学技术(TDM和/或MRI)完善诊断。仅在治疗时进行动脉造影。其病情发展可能差异很大(分为四个阶段:静止、扩张、破坏、失代偿),通常因激素变化或外伤而发展。不再推荐放疗和血管结扎术。最佳治疗方法是直接栓塞或经动脉栓塞。可行时,手术切除必须彻底。栓塞失败或复发时可考虑手术切除。