Rosenberg Tara L, Suen James Y, Richter Gresham T
Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Texas Children's Hospital Vascular Anomalies Center, Houston, 6701 Fannin Street, Suite D.0640, Houston, TX 77030, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, 1 Children's Way, Slot 836, Little Rock, AR 72202, USA.
Otolaryngol Clin North Am. 2018 Feb;51(1):185-195. doi: 10.1016/j.otc.2017.09.005.
Extracranial arteriovenous malformations (AVMs) are complex vascular malformations to diagnose and treat. They are comprised of congenitally derived arteriovenous shunts with chronic vascular expansion, collateralization, and infiltration of local tissue. Their cause remains unclear, but new genetic and molecular clues are emerging. They may present at any age following an early quiescent period. Diagnosis is based on vascular staining, soft tissue expansion, progressive growth, warmth, and pulsations. Focal lesions can be cured, whereas diffuse AVMs demonstrate highly recidivistic disease. Multimodal therapy with staged interventions can improve treatment outcomes, increase treatment intervals, and control disease. Vigilant follow-up is critical.
颅外动静脉畸形(AVM)是诊断和治疗都很复杂的血管畸形。它们由先天性动静脉分流组成,伴有慢性血管扩张、侧支循环形成和局部组织浸润。其病因尚不清楚,但新的遗传和分子线索正在出现。它们可能在早期静止期后的任何年龄出现。诊断基于血管染色、软组织扩张、进行性生长、发热和搏动。局灶性病变可以治愈,而弥漫性AVM则表现为高复发性疾病。采用分阶段干预的多模式治疗可以改善治疗效果、延长治疗间隔并控制病情。密切随访至关重要。