口腔颌面部血管瘤和血管畸形

作者回顾了本院１９８６～１９９０年５１３例口腔颌面部血管病变，复习病史、体检及病理切片，按Ｍｕｌｌｉｋｅｎ和Ｇｌｏｗａｃｋｉ提出新的血管病变生物学分类重新诊断。血管瘤和血管畸形在组织病理、临床表现完全不同；血管瘤在出生后一个月左右发现，能自然消退。血管畸形出生时就存在，不能退化，随患者生长而渐长大。血管瘤和血管畸形治疗方案也完全不同。     

口腔颌面部血管瘤治疗总结——附70例分析报告

<正> 血管瘤(Hemangioma)是口腔颌面部常见的疾病,多见于婴幼儿。随患者生长发育而增长,引起口腔颌面部毁容性畸形与功能障碍,发生大出血,继发感染时可致命。目前,血管瘤治疗方法报告虽多,但都有其不同的优缺点。对生后就存在的巨大血管瘤至今仍无特效治疗方法。探讨安全、简便、完全消除肿瘤,保持     

口腔颌面部血管瘤和血管畸形的治疗

口腔颌面部血管瘤和血管畸形的治疗北京医科大学口腔医学院（１０００８１）夏新国综述赵福运审阅由于血管病变的传统分类方法紊乱，给研究血管瘤的治疗带来非常不便。１９８２年Ｍｕｌｌｉｋｅｎ等［１］根据血管内皮细胞特性将以前所谓的“血管瘤”分为血管瘤和血管畸形...     

平阳霉素瘤内注射治疗口腔颌面部血管瘤、血管畸形的系统评价

目的 对平阳霉素瘤内注射治疗口腔颌面部、头颈部血管瘤和血管畸形的疗效和安全性进行客观公正的评价。方法 计算机及人工检索中文文献。将纳入文献报道的患者性别，年龄范围，血管瘤类型、部位、大小和治疗效果等进行合并，计算各种类型血管瘤的疗效。结果 纳入的31篇文献全部为l临床回顾性研究，非随机、非对照。平阳霉素对不同类型血管瘤的治愈率依次为：获得性血管瘤(1岁后发现的血管瘤，实际为血管畸形)100％，海绵状血管瘤72．6％。混合型血管瘤65．0％，毛细血管瘤64．6％(草莓状血管瘤66．0％)，脉管瘤60％。纤维性血管瘤21．4％。葡萄酒色斑4．8％．对蔓状血管瘤无效。平阳霉素的疗效优于鱼肝油酸钠。结论 目前资料显示，平阳霉素瘤内注射治疗血管瘤和血管畸形有一定疗效。应根据血管瘤和血管畸形的最新分类。重新进行前瞻性随机对照试验。     

平阳霉素治疗颌面部血管瘤常见后遗症及分析

目的　总结平阳霉素瘤内注射治疗颌面部血管瘤的后遗症及其原因。方法　收集 1995年 7月～ 2 0 0 1年 12月以来用平阳霉素治疗颌面部各类血管瘤并出现后遗症的患者 ,检查其治疗部位色、形、质的改变 ,要求每例患者都具有完整病历 ,且观察 1年以上无复发。结果　 9例颌面部血管瘤患者出现了后遗症 ,其中 3例患者畸形较严重 ,需手术整形。结论　平阳霉素治疗颌面部血管瘤疗效显著 ,但应考虑其剂量和部位等因素 ,否则有发生畸形的可能     

铜针栓塞术治疗颌面部海绵状血管瘤

铜针栓塞术治疗颌面部海绵状血管瘤湖南省常德市第二中医院口腔科（４１５０００）李恒忠血管瘤是先天性良性肿瘤或血管的畸形，发生于颌面部的血管瘤约占全身血管瘤的６０％［１］。我们近几年运用铜针栓塞术治疗８例颌面部的海绵状血管瘤，效果满意，现报道如下。临床资...     

埋线及缝扎治疗口腔颊面部血管瘤

埋线及缝扎治疗口腔颊面部血管瘤中山医科大学孙逸仙纪念医院口腔科（５１０１２０）庾尧炜陈光晔颌面部血管瘤是先天性良性肿瘤或血管畸形，目前的治疗方法有外科切除、放射治疗、低温治疗、激光治疗、硬化剂治疗等，一般采用综合疗法［１］。对于蔓状血管瘤治疗上多以结...     

颌面部血管瘤合并动静脉畸形：病例报告及文献复习

血管瘤和血管畸形虽是婴幼儿的常见病,但血管瘤能否与动静脉畸形合并发生却一直存在争议。作者报告1例颌面部巨大、多发性血管瘤伴动静脉畸形的新生儿病例,经α-干扰素皮下注射治疗,血管瘤基本消退,而动静脉畸形依然存在。该病例报告证实,血管瘤可与动静脉畸形并存发生,且干扰素治疗重症血管瘤具有显著疗效。     

海藻酸钠微球血管栓塞剂介入栓塞治疗口腔颌面部血管畸形

口腔颌面部血管畸形(vascular malformation,VM)既往泛称为口腔颌面部血管瘤,约占全身血管畸形的60%.     

90锶、90镱敷贴治疗颌面部血管瘤及脉管畸形疗效观察

目的　观察应用90 锶、90 镱敷贴器治疗婴幼儿颌面部血管瘤、脉管畸形的疗效。方法　采用多次小剂量90 锶、90 镱对 96例患儿颌面部血管瘤、脉管畸形进行敷贴治疗。结果　总有效率为 98.96 %。结论　90 锶、90 镱敷贴治疗婴幼儿颌面部血管瘤、脉管畸形操作简单、并发症少 ,疗效满意     

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颌面部脉管性疾病在临床上属于常见病,约占全身同类疾病的60%。由于颌面部脉管性疾病严重影响外观,可对患者及家属产生很大的心理负担。对于此类疾病的治疗方法较多,但有些治疗方法仍属不当,应该引起临床医生的注意。对于不同类型的脉管性疾病,应选择最适合的方法治疗,以取得最满意的治疗效果,达到颌面部整形美容的要求。     

Le anomalie vascolari dei tessuti molli del cavo orale

Objectives

To examine the vascular anomalies most frequently found in dental practice. Vascular anomalies are diseases characterized by functional and/or morpho-structural alterations of various nature, severity and extension which can affect every type of vessel (arterial, venous or lymphatic) of any caliber or anatomical region. Generally they are congenital and benign though they may cause complications such as ulceration, bleeding, superinfection, functional, and/or aesthetic deficit.

Materials and methods

Currently, the reference classification is the one adopted by the International Society for the Study of Vascular Anomalies (ISSVA), which distinguishes vascular or vasoproliferative neoplasms, including hemangiomas, from vascular malformations, these latter being further subdivided into low-flow and high bloodstream malformations. The diagnosis of vascular anomalies can not be separated by pathological history and clinical examination of the patient, even if for a certain diagnosis it is necessary to perform instrumental examinations including the echo color doppler ultrasound, a rapid examination, which is repeatable and devoid of ionizing radiation. The treatment involves different techniques, depending on the type of vascular lesion diagnosed; in particular, laser therapy is the most suitable for low-flow anomalies. This technique presents three different approaches: the excisional biopsy being indicated for suspicious lesions which need a histological examination; the transmucousal thermophotocoagulation (TMT) which involves the use of laser in “no contact” mode; and the intralesional photocoagulation (ILP) which uses the laser fiber inside the lesion and is suitable for deepest vascular anomalies.

Results and conclusions

. According to recent literature and clinical experience, we can say that vascular anomalies are a heterogeneous group of diseases for which treatment is necessary to perform a correct diagnostic clinical-instrumental approach; laser devices, with a wavelength similar to the oxidized hemoglobin, are the gold standard for the treatment of low flow blood abnormalities, both for ease of use and the excellent haemostatic effects.     

Vascular lesions of the maxillofacial region: a case report and review of the literature

There is frequently lack of understanding and apprehension among dental practitioners treating patients with vascular lesions of the oral and maxillofacial region. Arteriovenous malformations are rare lesions which can easily be misdiagnosed yet produce the very dramatic clinical presentation of severe life threatening oral bleeding. Much of this apprehension likely stems from a lack of understanding of these anomalies, including lesion behavior/ characteristics, clinical work-up, and treatment paradigms. A comprehensive, in depth review of the full spectrum of vascular lesions of the maxillofacial complex is beyond the scope of this review. The purpose of this article is to provide a comprehensive review of the diagnosis, treatment, and risks associated with these complex vascular anomalies and provide a case report. In 1982, Mulliken and Glowacki published a landmark article proposing characterization of vascular defects based on biologic and pathologic differences. Their work differentiated between two major categories of vascular lesions: hemangiomas and vascular malformations. Different categories, names, and treatment options have been advocated over the years with multiple outcomes. They can occur in various areas throughout the body, with 60 percent being located in the head and neck. The true mechanism of pathogenesis of vascular anomalies is still unclear. Embolization and surgery is often combined for extended cases to improve their facial contour and oral function. We present the case of a 29-year-old female that is 36 weeks pregnant and presented to University Hospital after having significant bleeding from her oral cavity. She was found to have a gingival lesion associated with a radiolucency in the right posterior mandible. During her stay she had an episode of acute bleeding that required an emergent exploration, embolization, and resection secondary to an Arteriovenous Malformation associated with the Inferior Alveolar Artery. We will discuss the presentation, treatment provided, and outcome of this patient. We will also cover the diverse group of congenital vascular malformations, and their pathologic, clinical, and radiologic diagnosis and management.     

第16届国际脉管性疾病学术研讨会述评

第16届国际脉管性疾病学术研讨会(16th International Workshop on Vascular Anomalies)于2006年6月14～17日在意大利米兰市Palazzo Mezzanotte举行。会议共收到论文200余篇,来自世界各地(以欧美为主)的300多名代表参加了会议。国际著名脉管性疾病专家Mulliken教授(美国)、Waner教授(美国)、Yakes教授(美国)、Enjolras教授(法同)、Boon教授(比利时)、Vikkula教授(比利时)、Mattassi教授(意大利),ISSVA主席Loose教授     

Surgical management of vascular lesions of the head and neck: a review of 115 cases

Vascular anomalies are amongst the most common congenital abnormalities observed in infants and children. Their occurrence in the head and neck region is a source of functional and aesthetic compromise. This article reviews the surgical management of 115 cases of vascular anomalies involving the head and neck area treated by the authors between 1998 and 2009. It discusses the diagnostic aids, treatment protocol and the results obtained. A new classification based on the anatomical location and depth of the lesion has been proposed. This allows guidelines for surgical ablation of the vascular lesions. The complications encountered are discussed. The use of external carotid artery control as opposed to pre-surgical embolization has proved effective and the technique is described. The location and extent of a vascular malformation should dictate the preoperative investigations, surgical procedure and subsequent outcome.     

Interdisziplinäres Konzept zur Diagnostik und Therapie gefäßreicher Fehlbildungen im Gesichts- und Halsbereich

Purpose. In patients with extended vascular anomalies in the head and neck, therapeutic decisions may pose a challenge to maxillofacial surgeons, dermatologists, and interventional radiologists. We analyzed the value of an interdisciplinary classification and treatment concept. Patients and methods. The classification distinguishes hemangiomas and vascular malformations. Whereas hemangiomas are endothelial proliferations, vascular malformations are considered to be developmental anomalies, which are further classified into high-flow or low-flow lesions and according to the vascular channels into capillary, venous, or lymphatic malformations. Since 2000 we have provided interdisciplinary consultation for patients with vascular anomalies. In patients with hemangiomas and venous malformations, the clinical diagnosis is confirmed by color-coded duplex sonography and magnetic resonance imaging; angiography is performed as part of the treatment planning for patients with arteriovenous malformations. Patients with hemangiomas are treated surgically by cryosurgery or laser surgery or conservatively according to lesion size and behavior. In patients with venous malformations, percutaneous sclerotherapy is combined with surgical reduction; patients with arteriovenous malformations undergo transarterial embolization prior to surgical excision of the nidus. Results. A total of 73 patients attended the interdisciplinary consultation. This group included 53 patients with facial hemangiomas, 7 with venous malformations, 2 with capillary malformations, 5 with lymphatic malformations, and 6 with high-flow arteriovenous malformations. Conclusions. The interdisciplinary protocol increases diagnostic accuracy and helps to establish individual treatment plans for patients with extended vascular anomalies.     

43rd National AOMSI Conference

Vascular anomalies of the head and neck region are a complex group of lesions that challenge the head and neck physicians. From the very understanding of the difference between its two distinct forms, hemangiomas and vascular malformations to its management remain confusing. The review of this anomaly attempts at comprehensively understanding the disease. Vascular anomalies are easily diagnosed by their clinical presentation, but choice of imaging and management for this spectrum of lesions is varied. The author attempts to categorize the required imaging for the lesion with suggestions on the management of both hemangiomas and vascular malformations. The available treatment options are discussed, and a comprehensive algorithm for management is suggested. Further research in developing drugs that could restrict the growth of these lesions would be the future of the management of vascular lesions.     

口颌面部动静脉畸形诊治指南

动静脉畸形(arteriovenous malformations,AVMs)是由于胚胎期脉管系统发育异常而导致动、静脉直接吻合所形成的血管团块,内含不成熟的动脉和静脉,而且血管团块中没有毛细血管,动静脉之间存在不同程度的直接交通.在血管瘤与血管畸形中,动静脉畸形相对少见,仅占1.5%左右,口腔颌面部是最好发的部位,占...     

聚桂醇硬化剂治疗口腔颌面部血管瘤和脉管畸形专家共识

[提要] 血管瘤和脉管畸形是一组复杂的来源于脉管系统的疾病。婴幼儿血管瘤以内皮细胞增殖为特征,是最常见的婴幼儿良性肿瘤。脉管畸形是胚胎发育时期脉管系统发育异常所致,超过60%的脉管畸形发生于头颈部。血管瘤和脉管畸形可能引起严重的面部畸形和功能障碍,硬化治疗是其常用的治疗方法。过去常用的硬化剂有平阳霉素、博来霉素、无水乙醇、十四烷基硫酸钠、OK-432、强力霉素、鱼肝油酸钠等。近年来,国产硬化剂聚桂醇被广泛用于血管瘤和脉管畸形的治疗,泡沫化硬化治疗技术的发展推动了其临床应用,其治疗有效性和安全性已被大量研究所证实。为了进一步规范该技术的应用,我们组织专家制定了该专家共识。今后将依据最新出版的文献和临床治疗经验及时更新,为该领域的临床医师提供指导。     

Intraosseous ‘haemangioma’ of the zygoma: More appropriately termed a venous malformation

Vascular anomalies often affect the soft tissues and primary intraosseous lesions are uncommon, with only 33 cases reported in the zygoma. Intraosseous vascular anomalies of the zygoma have traditionally been designated ‘haemangiomas’ with little attempt to clarify the specific type of the lesion. Recently, specific immunohistochemical markers such as erythrocyte type glucose transporter protein 1 (GLUT-1) have been described to differentiate haemangiomas and vascular malformations. The authors report a case of intraosseous venous malformation of the zygoma and provide supporting evidence to justify the nomenculature. The literature on zygomatic ‘haemangiomas’ is critically reviewed and the basis for their proper designation as venous malformations highlighted.