Matsumiya Toshie, Nemoto Hitoshi, Kasai Yoshiaki, Maruyama Naoki, Sumiya Noriyoshi
Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan.
Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan.
Int J Surg Case Rep. 2015;12:132-6. doi: 10.1016/j.ijscr.2015.04.032. Epub 2015 May 8.
Venous malformations of the zygoma are rare. Historically, venous malformations have been misrepresented as "hemangiomas". The International Society for the Study of Vascular Anomaly (ISSVA) classification is a reasonable classification that leads to appropriate clinical diagnosis and treatment strategies. Collaboration between surgeons, radiologists, and pathologists is necessary for accurate diagnosis and management.
We present here a case of an IOVM in a 59-year-old woman who was treated with a multidisciplinary approach. Superselective arteriography and embolization were effective for diagnosis as well as for prevention of large hemorrhage during surgery. En-bloc resection of the zygoma was performed within hours after embolization and autologous calvarial bone graft was used for primary reconstruction.
We performed a literature review consisting of reviewing 52 cases of IOVM of the zygoma discussing optimal material for reconstruction of the defect for intraosseous venous malformation of the zygoma nationally and internationally.
The combination of surgery and preoperative angiography makes it possible to prevent high risk of hemorrhage. For primary reconstruction of the zygoma, use of autologous calvarial bone can maintain the volume and reconstruct the natural malar contour.
颧骨静脉畸形较为罕见。历史上，静脉畸形一直被误诊为“血管瘤”。国际血管畸形研究学会（ISSVA）分类是一种合理的分类方法，有助于进行恰当的临床诊断和制定治疗策略。外科医生、放射科医生和病理科医生之间的合作对于准确诊断和管理至关重要。
我们在此呈现一例59岁女性眶内静脉畸形（IOVM）的病例，该病例采用了多学科治疗方法。超选择性动脉造影和栓塞术对于诊断以及预防手术期间的大出血均有效。在栓塞术后数小时内进行了颧骨整块切除，并使用自体颅骨骨移植进行一期重建。
我们进行了一项文献综述，回顾了52例颧骨IOVM病例，在国内和国际范围内讨论了颧骨骨内静脉畸形缺损重建的最佳材料。
手术与术前血管造影相结合能够预防大出血的高风险。对于颧骨的一期重建，使用自体颅骨骨可以维持体积并重建自然的颧部轮廓。
