Department of Oral and Maxillofacial Surgery (Head: Rainer Schmelzeisen, PhD, MD, DDS), University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany.
J Craniomaxillofac Surg. 2013 Apr;41(3):258-64. doi: 10.1016/j.jcms.2012.10.005. Epub 2012 Dec 14.
Arteriovenous malformations (AVM) of the head and neck are rare conditions with the majority of primary sites in the mid-face. Progression can lead to massive life-threatening bleeding. Treatment of choice is the combination of embolization and surgical resection. Diagnosis and management of AVM has been facilitated in recent years by the progress in imaging techniques and various microsurgical and endovascular embolization procedures.
This report presents the interdisciplinary approach to a case of life-threatening AVM of the mid-face in a 30-year-old patient.
Angiography with embolization followed by resection and plastic reconstruction was performed. Follow-up showed incomplete obliteration of the AVM and lead to additional embolizations via the anastomosed radial artery. Complete eradication of the AVM was not possible during the three year follow-up period.
In extensive vascular malformations of the head and neck, complete surgical removal is often impossible and associated with high risk of complications and mortality. Endovascular embolization is limited by the location of the AVM and can potentially cause stroke, ischaemia, necrosis, bleeding, blindness and adverse haemodynamic changes.
头颈部动静脉畸形（AVM）是一种罕见的疾病，大多数原发性部位在中面部。病情进展可导致危及生命的大出血。治疗的首选方法是栓塞和手术切除相结合。近年来，随着影像学技术和各种显微外科及血管内栓塞技术的进步，AVM 的诊断和治疗变得更加容易。
本报告介绍了一名 30 岁患者中面部危及生命的 AVM 的多学科治疗方法。
进行了血管造影栓塞，随后进行了切除和整形重建。随访显示 AVM 不完全闭塞，并通过吻合的桡动脉进行了额外的栓塞。在三年的随访期间，无法完全消除 AVM。
在头颈部广泛的血管畸形中，完全手术切除通常是不可能的，且存在高并发症和死亡率风险。血管内栓塞受 AVM 位置限制，可能导致中风、缺血、坏死、出血、失明和不良血流动力学改变。
