Ye Zelin, Li Chenyang, Liu YuanYuan, You Meng
State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
J Craniomaxillofac Surg. 2023 Jul-Aug;51(7-8):490-496. doi: 10.1016/j.jcms.2023.07.001. Epub 2023 Aug 2.
The objective of this study is to provide a comprehensive summary of the clinical and radiological features of zygomatic intraosseous venous malformations (IVM), as well as its treatment strategies. The aim is to establish preoperative diagnostic bases that will aid in the identification of zygomatic IVM and facilitate the implementation of effective treatment. Four cases of pathologically diagnosed zygomatic IVM with typical clinical and radiological features were reported. They exhibited comparable clinical and radiological features, and the En bloc excision and reconstruction yielded satisfactory outcome. Pooled data analysis was performed with additional 74 cases collected from 63 previous studies. The results revealed a higher incidence of zygomatic IVMs in middle-aged females, with swelling, pain and ocular dysfunction being the typical clinical manifestations. The characteristic radiological features of these lesions were well-defined, round bony structures with specific internal trabecular patterns. A diagnostic flow-chart assisting the differential diagnosis of IVM was established. En bloc excision was deemed the most advantageous treatment option, as it presented minimal risk of haemorrhaging and no instances of recurrence. The decision to pursue reconstruction was contingent upon the extent of the defect. Alloplastic material has emerged as the most frequently employed reconstruction material in recent reports. The summarized characteristics of zygomatic IVM and the proposed diagnostic and treatment strategies, derived from the pooled analysis of reported cases, may help to improve diagnosis and management in further clinical practice.
本研究的目的是全面总结颧骨骨内静脉畸形（IVM）的临床和放射学特征及其治疗策略。目的是建立术前诊断依据，以帮助识别颧骨IVM并促进有效治疗的实施。报告了4例经病理诊断的具有典型临床和放射学特征的颧骨IVM。它们表现出可比的临床和放射学特征，整块切除和重建取得了满意的结果。对从先前63项研究中收集的另外74例病例进行了汇总数据分析。结果显示，中年女性颧骨IVM的发病率较高，肿胀、疼痛和眼部功能障碍是典型的临床表现。这些病变的特征性放射学特征是边界清晰的圆形骨质结构，具有特定的内部小梁模式。建立了有助于IVM鉴别诊断的诊断流程图。整块切除被认为是最有利的治疗选择，因为它出血风险最小且无复发情况。是否进行重建取决于缺损的程度。在最近的报告中，异体材料已成为最常用的重建材料。从报告病例的汇总分析中得出的颧骨IVM的总结特征以及提出的诊断和治疗策略，可能有助于在进一步的临床实践中改善诊断和管理。
