Morphological characteristic of capillary malformations of head and neck

Abstract

Introduction: the capillary malformations of head and neck are combined pathologies of the bloodstream which are characterized by a variety of structural changes of the bloodstream itself, as well as adjoining tissues. The efficiency of surgical treatment and absence of recurrences depend on the knowledge of peculiarities of the bloodstream structure in the capillary malformation zone and its periphery.The aim of the research: to study the morphological characteristic of capillary malformations of head and neck.Materials and methods: the operational material of simple and combined capillary malformations of head and neck of 30 patients (age 18–50 years old) was analyzed. The patients had been being treated since 2000 till 2013 at the department of the restorative microvascular surgery of the National Institute of Surgery and Transplantology named after A.A. Shalimov of NAMS of Ukraine.Histological study was provided by means of fixing the material in 10% formalin solution with the phosphate buffer. The materials were processed using the standard histological method, the sections were stained by hematoxylin and eosin, azure-II-eosin, resorcin-fuchsin, PAS reaction with fermentation control was made.The results: Simple and combined capillary malformations of head and neck were defined into 3 groups according to pathohistological investigation of the operation materials. Groups had significant structural differences: capillary, nodular capillary malformations, capillary arteriovenous malformations. The first group was formed by 12 cases (40,0%) of simple capillary malformations. Presence of a big number of enlarged capillaries of various diameter or venules of the middle size was typical for this type of malformations. The second group was formed by 3 patients (10,0%) with capillary malformations and nodular formations. The structure of the nodular formation resembles a simple capillary malformation. But some vessels, which are the parts of not formed or partially formed arteriovenous anastomosis, were found. The third group was formed by the cases of combined capillary-arteriovenous malformations with all typical signs of capillary malformations combined with arteriovenous micro shunts. The group was formed by 15 patients (50%). The presence of the arteriovenous micro shunts was a determinative criterion for the differential diagnosis.The conclusion: It is rational to distinguish three types of the capillary malformations: simple capillary malformations, simple capillary malformations with the nodular formations and combined capillary-arteriovenous malformations. According to the results of the study the combined capillary-arteriovenous malformations cases are the most frequent. The cases of simple capillary malformations with the nodular formations are less frequent (2nd place). The surgical tactics for the patients must be determined by the type of the malformation (simple capillary or combined forms).