Intralesional injection of Pingyangmycin for vascular malformations in oral and maxillofacial regions: An evaluation of 297 consecutive patients

Abstract

The purpose of the study was to investigate the indications and treatment results of intralesional injection of Pingyangmycin for vascular malformations in oral and maxillofacial regions. Between June 2002 and July 2007, 297 patients with oral and maxillofacial vascular malformations (except venular malformation and arteriovenous malformation) were treated with percutaneous injection of Pingyangmycin in our department. There were 159 males and 138 females aged from 8 months to 72 years (mean age 20.6 years). The types of the disease included 98 lymphatic malformations (66 microcystic and 32 macrocystic malformations), 179 venous malformations, and 20 mixed lymphatic-venular or venous malformations. The lesions were located in the oral and maxillofacial and head and neck regions, and measured 0.8 cm x 1.0 cm -12.4 cm x 10.5 cm in size. Two hundred and forty-nine patients underwent intralesional injection of Pingyangmycin alone, 30 patients had laser therapy, and 18 patients underwent surgical excision as well. The number of injection sessions was 1-5, with an average of 3.5 times. Pingyangmycin, dexamethasone, and lidocaine were mixed for injection at concentrations of 1.0mg of Pingyangmycin per milliliter for microcystic lymphatic malformation and 2.0mg of Pingyangmycin per milliliter for venous malformation and macrocystic lymphatic malformation. The patients were followed up for 1-6 years after treatment. The results were evaluated based on B-type ultrasound examinations before and after treatment. The clinical cure rate of venous malformation, macrocystic lymphatic malformation, microcystic lymphatic malformation and mixed malformation was 74.86%, 84.38%, 38.88%, and 60.0%. Five patients had fever. No ulceration, necrosis, or anaphylactic reaction was found. Intralesional injection of Pingyangmycin at an adequate concentration can be used as the therapy of choice for small and medium-sized venous malformations, macrocystic lymphatic malformations, microcystic lymphatic malformations, and mixed malformations. The advantages included a high cure rate, safety and reliability, short course, easy manipulation, and fewer side effects with satisfactory recovery of appearance and function.