Image-guided percutaneous sclerotherapy of venous malformations of the head and neck: Clinical and MR-based volumetric mid-term outcome

We performed a systematic review and meta-analysis of studies performing sclerotherapy for treatment of venous malformations (VMs) of the face, head and neck. It is our hope that data from this study could be used to better inform providers and patients regarding the benefits and risks of percutaneous sclerotherapy for treatment of face, head and neck VMs. We searched PubMed, MEDLINE, and EMBASE from 2000–2018 for studies evaluating the safety and efficacy of percutaneous sclerotherapy of neck, face and head VMs. Two independent reviewers selected studies and abstracted data. The primary outcomes were complete and partial resolution of the VM. Data were analyzed using random-effects meta-analysis. Thirty-seven studies reporting on 2,067 patients were included. The overall rate of complete cure following percutaneous sclerotherapy with any agent was 64.7% (95% confidence interval [CI], 57.4–72.0%). Sodium tetradecyl sulfate had the lowest complete cure rate at 55.5% (95% CI, 36.1–74.9%) while pingyangmycin had the highest cure rate at 82.9% (95% CI, 71.1–94.7%). Overall patient satisfaction rates were 91.0% (95% CI, 86.1–95.9%). Overall quality of life improvement was 78.9% (95% CI, 67.0–90.8%). Overall permanent morbidity/mortality was 0.8% (95% CI, 0.3–1.3%) with no cases of mortality. Our systematic review and meta-analysis of 37 studies and over 2,000 patients found that percutaneous sclerotherapy is a very safe and effective treatment modality for treatment of VMs of the head, neck and face.

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Percutaneous sclerotherapy with ethanolamine oleate for venous malformations of the head and neck

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2013-010924 ◽

2013 ◽

Vol 6 (9) ◽

pp. 695-698 ◽

Cited By ~ 9

Author(s):

Matthew David Alexander ◽

Ryan A McTaggart ◽

Omar A Choudhri ◽

Mary L Marcellus ◽

Huy M Do

Keyword(s):

Head And Neck ◽

Venous Malformations ◽

Ethanolamine Oleate ◽

Percutaneous Sclerotherapy

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Percutaneous Sclerotherapy of Venous Malformations of the Head and Neck Using Sodium Tetradecyl Sulphate (Sotradecol)

Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery ◽

10.3109/02844319709085481 ◽

1997 ◽

Vol 31 (2) ◽

pp. 145-150 ◽

Cited By ~ 92

Author(s):

Topi M. J. Siniluoto ◽

Paul A. Svendsen ◽

Gunnar M. Wikholm ◽

Ingemar Fogdestam ◽

Staffan Edström

Keyword(s):

Head And Neck ◽

Venous Malformations ◽

Percutaneous Sclerotherapy ◽

Sodium Tetradecyl Sulphate

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Ethanol sclerotherapy of head and neck venous malformations

Einstein (São Paulo) ◽

10.1590/s1679-45082014ao2844 ◽

2014 ◽

Vol 12 (2) ◽

pp. 181-186 ◽

Cited By ~ 14

Author(s):

José Luiz Orlando ◽

José Guilherme Mendes Pereira Caldas ◽

Heloisa Galvão do Amaral Campos ◽

Kenji Nishinari ◽

Mariana Krutman ◽

...

Keyword(s):

Head And Neck ◽

Complete Resolution ◽

Intralesional Injection ◽

Low Doses ◽

Venous Malformations ◽

Ethanol Sclerotherapy ◽

Percutaneous Sclerotherapy ◽

Effective Treatment Modality ◽

Median Period ◽

The Face

Objective This retrospective study evaluated the results of sclerotherapy with low doses of ethanol for treatment of head and neck venous malformations.Methods We treated 51 patients, 37 females. Median age was 23 years. Patients were treated with percutaneous intralesional injection of alcohol every two weeks and followed up prospectively for a median period of 18 months. Most lesions affected the face and cosmetic disfigurement was the most frequent complaint.Results We performed a median of 7 sessions of sclerotherapy. Complete resolution or improvement was observed in 48 patients presented. Five cases of small skin ulceration, two cases of hyperpigmentation and two of paresthesia were documented; all of them were treated conservatively.Conclusion Percutaneous sclerotherapy with low doses of ethanol is a safe and effective treatment modality for venous malformations affecting the head and neck.

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Real-time MRI-guided percutaneous sclerotherapy treatment of venous low-flow malformations in the head and neck

Phlebology The Journal of Venous Disease ◽

10.1177/0268355517710110 ◽

2017 ◽

Vol 33 (5) ◽

pp. 344-352 ◽

Cited By ~ 2

Author(s):

Sasan Partovi ◽

Ziang Lu ◽

Lorenna Vidal ◽

Dean A Nakamoto ◽

Ji Buethe ◽

...

Keyword(s):

Head And Neck ◽

Real Time ◽

Low Flow ◽

Venous Malformations ◽

Needle Placement ◽

Ethanolamine Oleate ◽

Percutaneous Sclerotherapy ◽

Institutional Experience ◽

Mri Guided ◽

Truefisp Sequence

Purpose This manuscript describes the technique of real-time MRI-guided sclerotherapy for low-flow venous malformations in the head and neck based on our institutional experience. Materials and methods Ethanolamine oleate is used as the sclerosant and is mixed with gadolinium for visualization during the procedure. The five procedural steps include: (I) an initial tri-plane T2-weighted sequence to visualize the lesion; (II) a T1 FSE or trueFISP sequence to assess needle placement and advancement within the lesion; (III) a tri-plane T1 FLASH sequence to monitor sclerosant injection; (IV) a T1 FSE or VIBE sequence to assess sclerosant coverage of the malformation before needle removal; (V) a post-procedural tri-plane T1 fat-saturated sequence to confirm sclerosant coverage of the lesion. Periprocedural medications typically include steroids, antibiotic prophylaxis, and non-steroidal anti-inflammatory medication. Patients are typically admitted for overnight observation. Conclusion Real-time MRI-guided sclerotherapy for low-flow venous malformations in the head and neck is effective and safe.

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Percutaneous sclerotherapy for spongiform venous malformations – analysis of patient-evaluated outcome and satisfaction

VASA ◽

10.1024/0301-1526/a000650 ◽

2017 ◽

Vol 46 (6) ◽

pp. 477-483

Author(s):

Robert Karl Clemens ◽

Frederic Baumann ◽

Marc Husmann ◽

Thomas Oleg Meier ◽

Christoph Thalhammer ◽

...

Keyword(s):

Retrospective Study ◽

Medical Records ◽

Venous Malformation ◽

Primary Treatment ◽

Venous Malformations ◽

Treated Area ◽

Item Questionnaire ◽

Percutaneous Sclerotherapy ◽

Multiple Treatments ◽

Pain Improvement

Abstract. Background: Congenital venous malformations are frequently treated with sclerotherapy. Primary treatment goal is to control the often size-related symptoms. Functional impairment and aesthetical aspects as well as satisfaction have rarely been evaluated. Patients and methods: Medical records of patients who underwent sclerotherapy of spongiform venous malformations were reviewed and included in this retrospective study. The outcome of sclerotherapy as self-reported by patients was assessed in a 21 item questionnaire. Results: Questionnaires were sent to 166 patients with a total of 327 procedures. Seventy-seven patients (48 %) with a total of 159 procedures (50 %) responded to the survey. Fifty-seven percent of patients were male. The age ranged from 1 to 38.1 years with a median age of 16.4 years. The lower extremities were the most common treated area. Limitations caused by the venous malformation improved in the majority of patients (e.g. pain improvement 87 %, improvement of swelling 83 %) but also worsening of symptoms occurred in a minority of cases. Seventy-seven per cent would undergo sclerotherapy again. Conclusions: Sclerotherapy for treatment of venous malformations results in significant reduction of symptoms. Multiple treatments are often needed, but patients are willing to undergo them.

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Lugol Iodine Staining Test in Early Detection of Head and Neck Cancer

Revista de Chimie ◽

10.37358/rc.17.8.5797 ◽

2017 ◽

Vol 68 (8) ◽

pp. 1944-1945

Author(s):

Catalin Stefan ◽

Gabriel Lostun ◽

Alexandra Lostun

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Term Outcome ◽

Long Term Outcome ◽

Iodine Staining ◽

Examination Techniques ◽

Staining Techniques ◽

Malignant Lesions

Head and neck cancer represents 3% of malignancies, and it is associated with high mortality due to advanced stage diagnosis. In early stages, the symptomatology can either be absent or be very common, misleading the patient who often ignores it. Early diagnosis of head and neck neoplasia is essential for a favorable long-term outcome. Lately new in vivo examination techniques were developed, and older ones have been improved. Today, in vivo staining techniques are an important tool in the diagnostic of head and neck cancer. Lugol iodine staining method provides valuable information concerning the tumor, allowing the surgeon to differentiate premalignant and malignant lesions.

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