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静脉畸形是最常见的低流速脉管畸形,大多发生于头颈部,不仅影响患者面容,引发疼痛、溃疡、出血,还可压迫或侵及邻近组织器官,从而影响语言、吞咽及呼吸功能,甚至危及生命。静脉畸形的治疗方法包括手术、激光、硬化剂注射、电化学治疗等,但对范围广泛的巨大病变,则需多学科综合序列治疗方能达理想的治疗效果。本文旨在结合笔者的临床经验及国内外文献,对头颈部静脉畸形的综合序列治疗进行评述,强调无水乙醇硬化治疗在其中的重要性和必要性。由于无水乙醇注射可能引起严重并发症,建议此项操作由有经验的医师进行。

Multidisciplinaty approach to head and neck venous malformation

Venous malformation is the most common symptomatic low-flow vascular malformation， which predominantly occurred in the head and neck regions. They may be cosmetically disfiguring， cause pain， ulcerate， bleed， or compress or invade adjacent structures，and impede speech and swallowing and obstruct upper airway. Treatment methods include surgery， laser therapy and endovascular therapy with a fibrosing material. However， for those large and extensive lesions， multidisciplinary approach is required to achieve effective results. This paper summarizes current multidisciplinary approach to head and neck venous malformation based on the authors’ experience and relevant literature， emphasizing the importance of multidisciplinary approaches， as well as the essentiality of absolute ethanol sclerotherapy under DSA guidance for extensive venous malformation. Since alcohol embolotherapy can produce significant morbidity ， we propose the procedure be performed by experienced doctors.