Single-stage Embolisation Followed by Excision for Vascular Malformations at the Head or Neck
JB Chiang, HS Fung, WL Poon, PCM Chan, MWY Leung, C Liu, EYM Li, TCY Chan, ACO Cheng, KL Yuen, KW Tang
Hong Kong J Radiol 2018;21:115-20
DOI: 10.12809/hkjr1816422
Objective: To review the safety, efficacy, and outcome of single-stage embolisation with n-butyl cyanoacrylate (n-BCA) followed by surgical resection for head and neck vascular malformations.
Methods: Medical records of patients who underwent single-stage embolisation with n-BCA followed by surgical resection for vascular malformations at the head and neck region between October 2011 and April 2015 were retrospectively reviewed.
Results: A total of 10 men and 17 women (mean age, 36.7 years) was included. Symptoms included disfigurement (n = 27), haemorrhage (n = 4), and visual impairment (n = 2). The mean lesion size in the largest dimension was 2.9 cm. Lesions were located in the scalp (n = 4), orbit (n = 11), oral cavity (n = 3), lip (n = 3), face (n = 4), and
neck (n = 2). The mean operating time was 201 minutes. Five patients required further embolisation during surgery; 18 patients had complete resection and nine had partial resection. The mean length of hospital stay was 4.7 days; 22 patients had uneventful recovery and the other five had minor complications. The mean follow-up period was 20.6 months. All patients had good cosmetic outcome and symptom control. One patient who underwent partial resection had recurrent symptoms but required no further treatment.
Conclusions: Single-stage embolisation with n-BCA followed by surgical excision for management of vascular malformations of the head and neck region is safe and effective with minimal complications.
Author affiliation(s):
JB Chiang, HS Fung, WL Poon, KW Tang: Department of Radiology and Imaging, Queen Elizabeth Hospital, Jordan, Hong Kong
PCM Chan, MWY Leung, C Liu: Department of Surgery, Queen Elizabeth Hospital, Jordan,
Hong Kong
EYM Li, TCY Chan, ACO Cheng, KL Yuen: Hong Kong Eye Hospital, Ma Tau Wai, Hong Kong
中文摘要
單階段栓塞和切除頭頸部血管畸形
蔣碧茜、馮漢盛、潘偉麟、陳志滿、梁偉業、廖思維、李琬微、陳頌恩、鄭智安、袁國禮、鄧國穎
目的：回顧使用氰基丙烯酸正丁酯（n-BCA）進行單階段栓塞然後手術切除頭頸部血管畸形的安全性、有效性和結果。
方法：回顧分析2011年10月至2015年4月接受單階段n-BCA栓塞然後手術切除頭頸部血管畸形患者的病歷資料。
結果：納入10名男性和17名女性（平均年齡36.7歲）。症狀包括毀容（n = 27）、出血（n = 4）和視力受損（n = 2）。平均病變最大直徑為2.9厘米。病變位於頭皮（n = 4）、眼眶（n = 11）、口腔（n = 3）、唇部（n = 3）、面部（n = 4）和頸部（n = 2）。平均手術時間為201分鐘。五名患者在手術期間需要進一步栓塞。18例患者病變完全切除，9例有部分切除。平均住院時間為4.7天。22例患者康復，5例有輕微併發症。平均隨訪期為20.6個月。所有患者有良好的美容效果和症狀控制。只有一名患者切除部分病變後有復發性症狀但毋須進一步治療。
結論：單階段n-BCA栓塞然後手術切除頭頸部血管畸形安全有效並將併發症減至最低。