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极广泛血管畸形患者进行简单牙科手术需特殊准备——病例报告

Extremely Extensive Vascular Malformation Requires Special Preparation for Simple Dental Surgical Procedures-Case Report.

作者信息

Muczkowska Natalia, Masłowska Klaudia, Adamska Agnieszka

机构信息

Department of Oral Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland.

出版信息

Dent J (Basel). 2025 May 19;13(5):217. doi: 10.3390/dj13050217.

Abstract

Vascular anomalies represent a complex group of conditions including vascular malformations and haemangiomas. Haemangiomas are benign tumours that have an endothelial origin. In contrast, vascular malformations are characterized by the abnormal dilation of vessels without proliferation. Depending on the extension of the disease, there is a higher risk of life-threatening haemorrhages that may occur during simple dental procedures. The aim of this case report is to present the interdisciplinary treatment for patients with venous malformation and to discuss the possible dental management of these patients. A 66-year-old male patient with an extensive venous malformation of the head and neck was referred for a tooth extraction. The venous malformation involved lips, buccal mucosa, tongue, and floor of the oral cavity. Its proximity to the tooth requiring extraction was associated with a high risk of severe bleeding. Prior to the treatment, CBCT and CT scans were performed to confirm the extensions of the lesion and visualise its margins. Considering the possible risks related with venous malformation, the procedure consisted of tooth removal in a hospital setting with control over severe bleeding complications. The presence of an extensive vascular malformation in the head and neck region is burdened with a higher risk of haemorrhages during simple dental procedures. The radiological and clinical planning enables the choice of an accurate treatment strategy to avoid possible difficulties. In cases where such complications cannot be avoided, it is important to perform the treatment in a hospital setting with the cooperation of maxillofacial surgeons.

摘要

血管异常是一组复杂的病症,包括血管畸形和血管瘤。血管瘤是起源于内皮细胞的良性肿瘤。相比之下,血管畸形的特征是血管异常扩张但无增殖。根据疾病的累及范围,在简单的牙科手术过程中可能会出现危及生命的出血风险更高。本病例报告的目的是介绍静脉畸形患者的多学科治疗方法,并讨论这些患者可能的牙科处理。一名66岁男性患者因广泛的头颈部静脉畸形被转诊来拔牙。静脉畸形累及嘴唇、颊黏膜、舌头和口腔底部。其与需要拔除的牙齿位置接近,伴有严重出血的高风险。在治疗前进行了CBCT和CT扫描,以确认病变的范围并显示其边界。考虑到与静脉畸形相关的可能风险,该手术在医院环境中进行,同时控制严重出血并发症。头颈部存在广泛的血管畸形会在简单牙科手术期间有更高的出血风险。影像学和临床规划有助于选择准确的治疗策略以避免可能的困难。在无法避免此类并发症的情况下,在医院环境中与颌面外科医生合作进行治疗很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4172/12109861/1741bcc160e0/dentistry-13-00217-g001.jpg

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