Management of Arteriovenous Malformation in Otolaryngology Practice: A Retrospective Study & Review of Literature.

Abstract

Vascular malformations in the head and neck encompass a wide range of lesions and present an interesting challenge for the surgeon with their varied presentations. Early diagnosis and timely and adequate intervention help treat patients effectively. We reported our experience in the management of four patients diagnosed with low-flow venous malformation. Every patient was managed differently based on the site and size of the lesion, and all of them had the best outcome. 1 patient who had a smaller lesion was managed with oral propranolol, and 1 patient was managed with oral propranolol with local hot water injection. Two patients had larger lesions involving the airways and hence required an elective tracheostomy because of anticipated airway compromise, following which they were managed with intralesional sclerotherapeutic injection. As the lesion size shrank but remained, both underwent coblator-assisted tumor debulking at the end of two months. All four patients had a better outcome. Each patient received a different modality of treatment. No recurrences were noted in any of them. A multidisciplinary team approach resulted in a positive patient outcome. Vascular lesions should be considered in the differential diagnosis of a patient presenting with increasing dysphagia, dysphonia, or dyspnea. The cooperation of a skilled interventional radiologist cannot be over-emphasized.