Evaluation of sclerotherapy with different dilutions of ethanolamine oleate in the treatment of oral varicose veins

Bianca Montes Moraes,Bruna Lavinas Sayed Picciani,Karla Bianca Fernandes Da Costa Fontes,Mariana Marinho Arêdes,Cristiano Magalhães Moura Vilaça,Juliana Tristão Werneck,Maria Carolina De Lima Jacy Monteiro Barki Barki

doi:10.1590/1981-863720210004320200090

Bianca Montes Moraes, Bruna Lavinas Sayed Picciani + Show 5 more

Open Access

https://doi.org/10.1590/1981-863720210004320200090

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Abstract

ABSTRACT Objective: This study aim to evaluate the effectiveness of sclerotherapy protocols with different dilutions of ethanolamine oleate in the treatment of oral varicose veins. Methods: Clinical data and images of 14 cases treated with sclerotherapy were analyzed and descriptive analyses were performed. Results: Females (58%) and white skin color (83%) prevailed. Age varied between 14 and 79 years, with 47 years on mean (SD = 19 years). The most common anatomical locations were the buccal mucosa and lower lip. The final volume of the sclerosing agent (Ethamolin®) ranged from 0.4 to 4.3ml and the concentration ranged from 5% to 100%. The number of sessions ranged from 1 to 12 and the number of points per application was 1 to 7 points. Pain and edema were seen in 43% and 29% of patients, respectively. Conclusion: Sclerotherapy with monoethanolamine oleate diluted in anesthetic is a safe and effective option for the treatment of this lesion, regardless of concentration. However, edema and pain seem to be directly associated with increased drug concentration.

Highlights

Vascular anomalies are classified according to the determinations of the International Society for the Study of Vascular Anomalies (ISSVA), divided into tumors and Vascular Malformations (VMs)
The dilution was performed as follows: a) the patients were informed about the possibility of discomfort during and after the application of the medication; b) in a 1ml syringe, the dilution was made in a 1:20 ratio, using one part of Ethamolin and 19 parts of anesthetic (Alphacaine 100®, Lidocaine 2% with epinephrine 1: 100.000, DFL); c) the patient was scheduled to return within 7 to 14 days to assess the need for a new application; d) a progressively increasing by 5% of the drug at each session
We showed that sclerotherapy with monoethanolamine oleate with concentration varying between 5% and 100% is a safe, practical and effective option for the treatment of this type of lesion

Summary

Introduction

Vascular anomalies are classified according to the determinations of the International Society for the Study of Vascular Anomalies (ISSVA), divided into tumors and Vascular Malformations (VMs). Malformations can be simple (classified into capillaries, lymphatic or venous), combined to encompass larger vessels, or associated with other anomalies. Among the simple vascular malformations are varicose veins [1,2]. Varicose veins are the most common oral vascular lesions in adults, especially in the older population [3]. The lesions are flat or elevated, with color ranging from red to purple, influenced by their location, degree of vascular congestion and tissue depth [4]. Due to the possibility of progressive growth, this type of lesion is more likely to render local trauma, in addition to influencing oral function and aesthetics, especially in cases of large swelling [5]

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