Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
J Craniofac Surg. 2023;34(8):2410-2412. doi: 10.1097/SCS.0000000000009563. Epub 2023 Aug 3.
Venous malformations (VMs) are histopathologically benign but can greatly impair patients' quality of life. Screlothprapy is known to be effective in improving symptoms without a scar, but surgical resection of residual lesions is sometimes necessary due to inadequate reduction. However, there is no consensus on what criteria should be used to consider switching to surgical treatment, and individualized decisions must be made for each case. To investigate the factors that contribute to the lack of efficacy of sclerotherapy in reducing lesions and how to predict this, the authors performed a retrospective clinical imaging and histopathological study of 6 cases of labial vein malformations treated with sclerotherapy and 3 cases without sclerotherapy. Clinical image investigations are based on magnetic resonance imaging before and after sclerotherapy. The authors found a significant decrease in the percentage of cystic components in the total lesion of VMs after sclerotherapy. Histopathological investigations are based on resected VMs with or without sclerotherapy. Elastica van Gieson stains suggested a significant increase in fibrotic tissue inside VMs treated with sclerotherapy compared with those without. In conclusion, magnetic resonance imaging signal changes inside the VMs after sclerotherapy was observed, and it may reflect fibrosis of the tissue. These changes in the VMs after sclerotherapy may reduce the effect of sclerotherapy on tissue reduction should be considered.
静脉畸形(VMs)组织病理学上是良性的,但会极大地降低患者的生活质量。硬化疗法已被证实可有效改善症状而不留疤痕,但由于残余病变减少不充分,有时仍需要手术切除。然而,目前尚无共识确定应采用何种标准来考虑转为手术治疗,必须针对每个病例做出个体化决策。为了研究导致硬化治疗减少病变效果不佳的因素,以及如何预测这种情况,作者对 6 例接受硬化治疗和 3 例未接受硬化治疗的唇部静脉畸形患者进行了回顾性临床影像学和组织病理学研究。临床影像学研究基于硬化治疗前后的磁共振成像。作者发现硬化治疗后 VMs 总病变中囊性成分的百分比显著降低。组织病理学研究基于有或没有硬化治疗的切除的 VMs。弹力纤维 Van Gieson 染色表明,与未接受硬化治疗的 VM 相比,接受硬化治疗的 VM 内纤维组织明显增加。总之,在硬化治疗后观察到 VMs 内的磁共振成像信号变化,这可能反映了组织纤维化。这些硬化治疗后 VMs 的变化可能会降低组织减少的硬化治疗效果,应予以考虑。