Analysis of children and adolescents with venous and arteriovenous malformations of the head and neck

Introduction:

Venous (VM) and arteriovenous malformations (AVM) are malformations of the vascular system that are present at birth but may not be apparent until later in life.

Methods:

A retrospective analysis over 13 years of children and adolescents up to 18 years of age with VM and AVM of the head and neck of a clinic was performed with regard to clinical parameters, diagnostics, therapy and outcome.

Results:

83 (57f/26 m) children and adolescents with VM (n = 73) and AVM (n = 10) of the head and neck were analyzed. The mean age at first presentation was 9.1 years. The most frequent sites of VM were the oral cavity, cheek and lips. 8% of the patients had multifocal VM. The most common localizations of AVM were the auricle and lips. Typical symptoms of malformations were swelling, pain and bleeding. The most common imaging modality was MRI. 30% of the patients were already pretreated at other hospitals before, in many cases the presence of a hemangioma was assumed. The most frequently used therapy methods in VM were Nd:YAG laser therapy and conventional surgical (partial) resection. In 7 patients with AVM surgical (partial) resection was performed; in two patients there was a preoperative embolization of the supplying vessels. In most of the patients a complete surgical excision was impossible as the function had to be maintained. In 19% of the patients a watch-and-wait strategy was indicated.

Conclusion:

Due to their clinical course and prognosis, VM and AVM must be distinguished from hemangiomas. Despite various therapeutic options, they are often associated with functional and esthetic limitations.

Publication History

Publication Date:
23 April 2019 (online)