Resident, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Head and Neck Tumor Surgery, School of Stomatology, The Air Force Military Medical University, Xi'an, Shaanxi, China.
Associate Professor, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Head and Neck Tumor Surgery, School of Stomatology, The Air Force Military Medical University, Xi'an, Shaanxi, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Jul;130(1):25-31. doi: 10.1016/j.oooo.2020.02.003. Epub 2020 May 31.
The objectives of this study were to document the results of using fibrin glue (FG) combined with pingyangmycin (PYM) for the embolism and sclerotherapy of maxillofacial arteriovenous malformations (AVMs).
We reviewed the associated clinical data from December 2012 to June 2017 for 25 patients with maxillofacial AVMs. The major treatment method was direct percutaneous puncture and injection of FG combined with PYM. Treatment outcomes were assessed through physical examination, Doppler ultrasonography, computed tomography, and 3-dimensional computed tomography angiography scans. Follow-up time ranged from 12 months to 3 years after the last treatment (mean 21 months).
Of the 25 lesions, 80% showed greater than 90% reduction, 12% showed greater than 75% reduction, and 8% showed greater than 50% reduction. Superficial skin necrosis or mucous ulcer occurred in 3 patients and healed without intervention. Regrowth was observed in 3 patients with extensive lesions involving multiple anatomic regions.
These data suggest that embolization and sclerotherapy with the use of FG combined with PYM are safe and effective for the treatment of small- to medium-sized, locally dilated maxillofacial AVMs. For AVMs involving multiple anatomic regions, combined application of this approach with other options should be considered.
本研究旨在记录使用纤维蛋白胶（FG）联合平阳霉素（PYM）栓塞和硬化治疗颌面动静脉畸形（AVM）的结果。
我们回顾了 2012 年 12 月至 2017 年 6 月期间 25 例颌面 AVM 患者的相关临床资料。主要治疗方法为直接经皮穿刺，FG 联合 PYM 注射。通过体格检查、多普勒超声、计算机断层扫描和 3 维计算机断层血管造影扫描评估治疗效果。末次治疗后随访时间为 12 个月至 3 年（平均 21 个月）。
25 个病灶中，80%的病灶缩小超过 90%，12%的病灶缩小超过 75%，8%的病灶缩小超过 50%。3 例患者出现浅表皮肤坏死或黏膜溃疡，未经干预自行愈合。3 例广泛病变累及多个解剖区域的患者出现复发。
这些数据表明，使用 FG 联合 PYM 栓塞和硬化治疗小至中等大小、局部扩张的颌面 AVM 是安全有效的。对于涉及多个解剖区域的 AVM，应考虑将这种方法与其他方法联合应用。
