OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium.
Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium.
Head Face Med. 2023 Aug 1;19(1):32. doi: 10.1186/s13005-023-00376-z.
Depending on the diagnostic modality, the classification of vascular anomalies varies and so does the nomenclature. The 'International Society for the Study of Vascular Anomalies' (ISSVA) is the most widely accepted classification in the literature and is mainly based on the radiologic and clinical presentation. The aim of this article is to review the clinical practice of diagnosis and treatment of vascular anomalies in the head and neck region in a university hospital, with special focus on the nomenclature. All patients with a vascular anomaly presenting to the department of oral and maxillofacial surgery were reviewed in a retrospective manner. Nomenclature, diagnostic process, lesion characteristics, treatment and outcome were examined. The lesions were (re)classified according to the ISSVA classification. A total of 185 patients were identified, of which 12.4% (n = 23) had a congenital anomaly. After reclassification, the most common lesions were venous malformations (n = 47, 25.4%), followed by lobular capillary hemangiomas (n = 17, 9.2%). A group of 39 anomalies could not be further specified. One hundred and one patients (54,6%) received treatment, of which 93 were treated surgically (92,1% of treated patients). Endovascular treatment was considered in 41 patients but applied in only eight. This strict selection led to a low a complication rate. We provide an overview of the clinical practice in the management of vascular anomalies in a university hospital. The histology report is a source of miscommunication because clinicians use the ISSVA classification, while pathologists use the WHO classification. Every professional involved should be aware of the differences in classification and nomenclature.
根据诊断方式的不同，血管畸形的分类也有所不同，命名法也是如此。“国际脉管异常研究学会”（ISSVA）是文献中最广泛接受的分类，主要基于影像学和临床表现。本文旨在回顾大学附属医院头颈部血管畸形的诊断和治疗临床实践，重点介绍命名法。回顾性分析了口腔颌面外科就诊的所有血管畸形患者。检查了命名法、诊断过程、病变特征、治疗和结果。根据 ISSVA 分类对病变进行（重新）分类。共确定了 185 例患者，其中 12.4%（n=23）为先天性异常。重新分类后，最常见的病变是静脉畸形（n=47，25.4%），其次是小叶状毛细血管血管瘤（n=17，9.2%）。有一组 39 个异常无法进一步明确。101 例患者（54.6%）接受了治疗，其中 93 例接受了手术治疗（治疗患者的 92.1%）。41 例患者考虑血管内治疗，但仅 8 例实施。这种严格的选择导致了较低的并发症发生率。我们提供了大学附属医院血管畸形管理临床实践的概述。组织学报告是沟通不畅的一个来源，因为临床医生使用 ISSVA 分类，而病理学家使用世卫组织分类。每个相关专业人员都应该了解分类和命名法的差异。
