Department of Plastic Surgery, Affiliated Jinling Hospital, Medical School of Nanjing University.
Department of Plastic Surgery, Jinling Hospital, Nanjing School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China.
J Craniofac Surg. 2021 Sep 1;32(6):2172-2175. doi: 10.1097/SCS.0000000000007628.
Head and neck are the predilection sites of arteriovenous malformations (AVMs). Although embolization is the first-line treatment for AVMs, complete surgical removal of the lesion still has its value due to the best outcome with low recurrence rate. Here, the authors made a retrospective analysis on the surgical treatment of AVMs in the head and neck.
From January 2006 to December 2019, a total of 18 patients with AVMs in the head and neck were enrolled in this study, including 10 males. The Schobinger clinical staging, Yakes' angioarchitecture type, and surgical treatment were analyzed. The follow-up data were collected. Then, individual treatment strategies were summarized.
According to Schobinger clinical classification system, 6 patients were at stage I, 7 patients at stage II, and 5 patients at stage III. According to Yakes' AVM classification system, 3 Type I, 4 Type II, 5 Type III, and 3 Type IV were confirmed. 3 patients cannot be confirmed due to lacking of arteriographic data. Surgical treatments included simple surgical excision (8 patients), dilator therapy (6 patients), and skin grafting after surgical excision (4 patients). In the follow-up period, 2 patients had recurrence and accepted operation again. All patients were satisfied with the appearance.
Individual surgical treatment based on the clinical stage and angioarchitecture type can achieve satisfactory results in AVMs in the head and neck.
头颈部是动静脉畸形（AVM）的好发部位。虽然栓塞是 AVM 的首选治疗方法，但由于复发率低，病变的完全手术切除仍有其价值。在此，作者对头颈部 AVM 的手术治疗进行了回顾性分析。
从 2006 年 1 月至 2019 年 12 月，共纳入 18 例头颈部 AVM 患者，其中男 10 例。分析 Schobinger 临床分期、Yakes 血管构筑类型和手术治疗。收集随访资料，总结个体化治疗策略。
根据 Schobinger 临床分类系统，6 例为 I 期，7 例为 II 期，5 例为 III 期。根据 Yakes 的 AVM 分类系统，确诊为 1 型 3 例，2 型 4 例，3 型 5 例，4 型 3 例。3 例因缺乏血管造影资料无法确定类型。手术治疗包括单纯手术切除（8 例）、扩张器治疗（6 例）和切除后植皮（4 例）。随访期间，2 例复发，再次接受手术。所有患者对外观均满意。
根据临床分期和血管构筑类型进行个体化手术治疗，可对头颈部 AVM 取得满意的效果。
