Clinical study of sclerotherapy of maxillofacial venous malformation using absolute ethanol and pingyangmycin.

摘要

PURPOSE: The purpose of this study was to evaluate the outcomes of sclerotherapy of maxillofacial venous malformations by use of absolute ethanol and pingyangmycin (bleomycin A(5) hydrochloride). PATIENTS AND METHODS: We treated 23 consecutive patients with maxillofacial venous malformations by sclerotherapy with a combination of absolute ethanol and pingyangmycin under local anesthesia. The size of the lesions ranged from 2 cm x 2 cm to 12 cm x 10 cm. Venography showed the presence of large venous lakes. Venograms were obtained during the first procedure before and after injection of absolute ethanol (0.5-2.5 mL) to confirm the site of the nidus and assess the effect of sclerosis of the nidus and draining veins. Subsequently, 8 to 16 mg of pingyangmycin dissolved in 40 mL of saline solution was infused into the nidus by a dynamic infusion pump at a rate of 1 mL/min. If necessary, this procedure was repeated once in 2 or 4 weeks. The clinical outcomes and complications were evaluated. RESULTS: The duration of follow-up ranged from 6 to 37 months, with a mean of 20.3 months. Only 1 procedure was required in 3 patients, and the procedure was required to be repeated twice in 9 patients, 3 times in 7, and 4 times in 4. All the patients were satisfied with the treatment results, and excellent clinical results were obtained in 9 patients. There was no skin necrosis or nerve damage. CONCLUSIONS: Percutaneous sclerotherapy with the combined use of absolute ethanol and pingyangmycin is a safe and effective treatment for maxillofacial venous malformations.