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使用无水乙醇和/或聚多卡醇对累及咀嚼肌的颌面部静脉畸形进行经皮硬化治疗的有效性和安全性:病例系列

Effectiveness and safety of percutaneous sclerotherapy using absolute ethanol and/or polidocanol for maxillofacial venous malformations involving the masticatory muscles: A case series.

作者信息

Ishikawa Kosuke, Sasaki Satoru, Furukawa Hiroshi, Maeda Taku, Miura Takahiro, Sasaki Yuki, Yamamoto Yuhei, Funayama Emi

机构信息

Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

Department of Plastic and Reconstructive Surgery, Center for Vascular Anomalies, Tonan Hospital, Sapporo, Hokkaido, Japan.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2023 Mar;135(3):355-362. doi: 10.1016/j.oooo.2022.07.013. Epub 2022 Jul 30.

Abstract

OBJECTIVE

This study evaluated the effectiveness and safety of percutaneous sclerotherapy for maxillofacial venous malformations.

STUDY DESIGN

Patients who had venous malformations involving the masticatory muscles and who underwent sclerotherapy were enrolled in this retrospective study.

RESULTS

Twenty-four patients (13 female, 11 male; mean age 21 years) were analyzed. Major clinical symptoms were swelling (100%) and intralesional pain (54%). Intramuscular lesions involved the masseter muscle only in 38% of cases, both the masseter and temporalis muscles in 33%, all masticatory muscles in 21%, and the temporalis muscle only in 8%. Extramuscular involvement was observed in 58% of patients. Absolute ethanol and polidocanol were used as sclerosants. The mean number of sclerotherapy sessions per patient was 6.6 (range, 1-32). The mean follow-up duration after the first sclerotherapy session was 64.8 months (range, 6-178). The complications included paralysis of the facial nerve (25%), intraoral ulceration (8%), and hemoglobinuria (8%). The effectiveness of treatment was rated as excellent in 33% of cases, good in 46%, and fair in 21%. Better results were obtained in patients without extramuscular involvement.

CONCLUSION

Percutaneous sclerotherapy can be effective and safe for maxillofacial intramuscular venous malformations, especially for localized lesions of the masseter muscle.

摘要

目的

本研究评估经皮硬化治疗在颌面部静脉畸形中的有效性和安全性。

研究设计

本回顾性研究纳入了患有累及咀嚼肌的静脉畸形并接受硬化治疗的患者。

结果

分析了24例患者(13例女性,11例男性;平均年龄21岁)。主要临床症状为肿胀(100%)和病灶内疼痛(54%)。肌内病变仅累及咬肌的病例占38%,累及咬肌和颞肌的病例占33%,累及所有咀嚼肌的病例占21%,仅累及颞肌的病例占8%。58%的患者存在肌外受累。使用无水乙醇和聚多卡醇作为硬化剂。每位患者硬化治疗的平均次数为6.6次(范围1 - 32次)。首次硬化治疗后的平均随访时间为64.8个月(范围6 - 178个月)。并发症包括面神经麻痹(25%)、口腔内溃疡(8%)和血红蛋白尿(8%)。33%的病例治疗效果评为优,46%为良,21%为中。无肌外受累的患者治疗效果更好。

结论

经皮硬化治疗对于颌面部肌内静脉畸形可能是有效且安全的,尤其是对于咬肌的局限性病变。

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