翻瓣激光联合平阳霉素注射治疗口腔颌面部静脉畸形36例报道

目的：评价翻瓣激光联合平阳霉素注射治疗口腔颌面部静脉畸形的疗效及安全性。方法：先以外科手术翻瓣显露病变，应用Nd：YAG激光照射凝固静脉畸形病灶，使病变萎缩消退，残余病变配合平阳霉素注射治疗。共治疗36例13腔颌面部静脉畸形患者。随访1～84个月，平均随访时间42．5个月，治疗前、后经临床及影像学检查进行评估。结果：显效29例，占80．6％；有效7例，占19．4％；总有效率100％，无复发病例。22例腮腺咬肌区及面颊部静脉畸形患者中，5例出院时伴部分面神经损伤症状。术后随访观察3个月，经Buttes—Fisch面神经评分系统评估，3例得分为100分，完全恢复；2例分别获得94．7、98分，大部分恢复正常。结论：翻瓣激光结合平阳霉素注射治疗口腔颌面部静脉畸形，疗效及安全性满意。

Laser irradiation after surgical exposure of the lesions combined with Pingyangnlycin injection in the management of venous malformation in oral and maxillofacial region:Report of 36 cases

PURPOSE： To evaluate the efficacy and safety of management of venous malformation in oral and maxillofaeial region with laser irradiation after surgical exposure of the lesions and Pingyangmycin injection. METHODS： After surgical elevation of the flaps, continuous wave Nd ：YAG laser irradiation was delivered. The residual lesion was treated with Pingyangmycin injection. 36 cases of venous malformation in oral and maxillofacial region were treated using this combined modality.The patients followed up for 1 to 84 months （average： 42.5 months）, clinical and imaging examinations were carried out to evaluate the treatment outcomes. RESULTS： Among 36 cases, 29 had complete regression （80.6%）, 7 had partial regression（19.4%） .No ease developed recurrence. Among 22 cases with lesions in the parotid gland, masseter and buccal region, 5 experienced symptoms of facial nerve palsy. After a follow - up of 3 months, assessed with Burres - Fisch facial nerve scoring system, 3 cases had a score of 100 and completely recovered. 2 cases had a score of 94.7 and 98, respectively with incomplete recovery. CONCLUSIONS： The combination of surgical exposure of the lesion ,laser irradiation and Pinyangmycin injection is effective and safety in the treatment of venous malformation in oral and maxillofacial region. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality（Grant No. 08DZ2271100）.