Management of Vascular Malformations in Dangerous Area of Oral Cavity: The Iranian Experience and Review of Treatment Modalities

Somayeh Alirezaei, Maryam Baharvand, Masood Rezaei, Arash Azizi, Bita Tavakoli

Dental School, Islamic Azad University, Tehran, Iran.
Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Oral and Maxillofacial Medicine Department, Dental School, Islamic Azad University, Tehran, Iran.

DOI: 10.4236/ojst.2014.43018                

Abstract

Aim: To evaluate the effect of a highly potent corticosteroid (dexamethasone) in the treatment of vascular malformation when the location is difficult to reach and complications such as uncontrolled bleeding is predictable in surgery. Background: Vascular malformation is not a common lesion in oral cavity especially in alveolar ridge with extension to the pillar uvula. These lesions arise from capillary or venous malformations with various surgical or non-surgical treatment modalities. Case Description: We performed weekly intralesional injection of dexamethasone in a patient with a vascular malformation in alveolar ridge extending to the lingual side of alveolar ridge and posterior extension to the uvula. Complete resolution of lesion was observed after 6th injection. Conclusion: Intralesional injection of dexamethasone is a potentially curative method to treat oral vascular malformation. Clinical Significance: Injection of dexamethasone is a simple and cost-effective therapy that can be used as a safe treatment for vascular malformations prior to or as a substitute for surgery.

Keywords

Vascular Malformation; Intralesional Injection; Dexamethasone

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Finn, M.C., Glowacki, J. and Mulliken, J.B. (1983) Congenital Vascular Lesions: Clinical Application of a New Classification. Journal of Pediatric Surgery, 18, 894-900. http://dx.doi.org/10.1016/S0022-3468(83)80043-8
[2]	Mulliken, J.B. and Glowacki, J. (1982) Hemangiomas and Vascular Malformation in Infants and Children: A Classification Based upon Endothelia Characteristics. Plastic and Reconstructive Surgery, 69, 412-422. http://dx.doi.org/10.1097/00006534-198203000-00002
[3]	Jackson, I.T., Carreno, R., Potparic, Z. and Hussain, K. (1993) Vascular Malformations, and Lymphovenous Malformations: Classification and Methods of Treatment. Plastic and Reconstructive Surgery, 91, 1216-1230. http://dx.doi.org/10.1097/00006534-199306000-00006
[4]	Waner, M. and Suen, J.Y. (1999) Hemangiomas and Vascular Malformations of the Head and Neck. Wiley-Liss, New York, 1-12.
[5]	Pence, B., Aybey, B. and Ergenekon, G. (2005) Outcomes of 532 nm Frequency-Doubled Nd:YAG Laser Use in the Treatment of Port-Wine Stains. Dermatologic Surgery, 31, 509-517. http://dx.doi.org/10.1111/j.1524-4725.2005.31152
[6]	Poetke, M., Urban, P., Philipp, C. and Berlien, H.P. (2005) Hemangiomas-Classification, Diagnostic and Laser Treatment. Przeglad Flebologiczny, 13, 77-84.
[7]	Mathur, N.N., Rana, I., Bothra, R., Dhawan, R., Kathuria, G. and Pradhan, T. (2005) Bleomycinsclerotherapy in Congenital Lymphatic and Vascular Malformations of Head and Neck. International Journal of Pediatric Otorhinolaryngology, 69, 75-80. http://dx.doi.org/10.1016/j.ijporl.2004.08.008
[8]	Muir, T., Kirsten, M., Fourie, P., Dippenaar, N. and Ionescu, G.O. (2004) Intralesionalbleomycin Injection (IBI) Treatment for Haemangiomas and Congenital Vascular Malformations. Pediatric Surgery International, 19, 766-773. http://dx.doi.org/10.1007/s00383-003-1058-6
[9]	Yamaki, T., Nozaki, M. and Sasaki, K. (2000) Color Duplex-Guided Sclerotherapy for the Treatment of Venous Malformations. Dermatologic Surgery, 26, 323-328. http://dx.doi.org/10.1046/j.1524-4725.2000.99248.x
[10]	Rimon, U., Garniek, A., Galili, Y., Golan, G., Bensaid, P. and Morgan, B. (2004) Ethanol Sclerotherapy of Peripheral Venous Malformations. European Journal of Radiology, 52, 283-287. http://dx.doi.org/10.1016/j.ejrad.2003.09.010
[11]	Shireman, P.K., McCarthy, W.J., Yao, J.S. and Vogelzang, R.L. (1997) Treatment of Venous Malformations by Direct Injection with Ethanol. Journal of Vascular Surgery, 26, 838-844. http://dx.doi.org/10.1016/S0741-5214(97)70098-3
[12]	Yakes, W.F., Haas, D.K., Parker, S.H., et al. (1989) Symptomatic Vascular Malformations: Ethanol Embolotherapy. Radiology, 170, 1059-1066.
[13]	Berenguer, B., Burrows, P.E., Zurakowski, D. and Mulliken, J.B. (1999) Sclerotherapy of Craniofacial Venous Malformations: Complications and Results. Plastic and Reconstructive Surgery, 104, 12-15. http://dx.doi.org/10.1097/00006534-199907000-00003
[14]	de Lorimier, A.A. (1995) Sclerotherapy for Venous Malformations. Journal of Pediatric Surgery, 30, 188-193. http://dx.doi.org/10.1016/0022-3468(95)90558-8