Judith Neuschl, Ulrike Ernemann, Siegmar Reinert, Matthias Neuschl, Jürgen Hoffmann
Department of Oral and Maxillofacial Surgery (Head: Professor Dr. Dr. J. Wiltfang), University Hospital Schleswig-Holstein, Campus Kiel, Osianderstr. 2-8, D-72076 Kiel, Germany.
Department of Diagnostic and Interventional Neuroradiology (Head: Professor Dr. U. Ernemann), University Hospital Tübingen, Hoppe-Seyler-Straße 3, D-72076 Tübingen, Germany.
J Craniomaxillofac Surg. 2014 Oct;42(7):1300-4. doi: 10.1016/j.jcms.2014.03.014. Epub 2014 Apr 1.
Venous malformations are the most common type of vascular malformation, usually detected at birth or during puberty. By occurring during human growth or through localized trauma, pain, functional impairment and aesthetic disfigurement is often observed. Ultrasonography, Doppler flow Imaging, and Magnetic Resonance Imaging are the most informative techniques which reveal the extent of tissue involvement and differentiate between high and low flow anomalies. Therapeutic options for treatment of venous malformations are sclerotherapy with alcohol, ethoxysclerol and bleomycin, laser therapy (Nd:YAG), surgery and combined therapeutic modalities. The aim of percutaneous sclerotherapy is the successive reduction of the volume of the lesion by aseptic inflammation.
This is a review of 51 patients with venous malformation treated by the Interdisciplinary Center for Vascular Anomalies at the University Hospital Tübingen, (Germany), from July, 2002 until January, 2007. The mean age of first consultation in our outpatient department was 26.4 years (median). 12 patients were treated by sclerotherapy with highly concentrated alcohol, 9 by surgery, and 7 by laser therapy. In some cases we combined different treatments. 9 patients had only sclerotherapy, while 3 had a combination of pre-operative sclerotherapy and surgery.
We obtained positive results in patients treated with sclerotherapy and combined sclerotherapy and surgery.
Sclerotherapy is safe (under fluoroscopic control), efficient, and can be repeated multiple times. Therefore, it should be considered as first-line treatment in venous malformations. A combination of a sclerotherapy with surgery is also useful in many cases.
静脉畸形是最常见的血管畸形类型，通常在出生时或青春期被发现。由于其在人体生长过程中出现或因局部创伤导致，常伴有疼痛、功能障碍和美观受损。超声检查、多普勒血流成像和磁共振成像等技术是最具诊断价值的方法，可揭示组织受累程度并区分高流量和低流量异常。静脉畸形的治疗选择包括使用酒精、乙氧硬化醇和博来霉素进行硬化治疗、激光治疗（钕：钇铝石榴石）、手术以及联合治疗方式。经皮硬化治疗的目的是通过无菌性炎症逐渐缩小病变体积。
本文回顾了德国图宾根大学医院血管畸形跨学科中心在2002年7月至2007年1月期间治疗的51例静脉畸形患者。在我们门诊首次咨询时的平均年龄为26.4岁（中位数）。12例患者接受了高浓度酒精硬化治疗，9例接受了手术治疗，7例接受了激光治疗。在某些情况下，我们采用了不同治疗方法的联合。9例患者仅接受了硬化治疗，而3例患者接受了术前硬化治疗与手术的联合治疗。
我们在接受硬化治疗以及硬化治疗与手术联合治疗的患者中取得了积极的治疗效果。
硬化治疗是安全的（在荧光透视控制下）、有效的，并且可以多次重复。因此，它应被视为静脉畸形的一线治疗方法。在许多情况下，硬化治疗与手术的联合应用也很有用。
