Oral Surgical Procedures Performed Safely in Patients With Head and Neck Arteriovenous Malformations: A Retrospective Case Series of 12 Patients

• Published in: Journal of oral and maxillofacial surgery Vol. 74; no. 2; pp. 255.e1 - 255.e8
• Main Authors: Karim, Abdul Basit, DDS, Lindsey, Sean, DDS, Bovino, Brian, DMD, Berenstein, Alejandro, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2016
• Subjects: Adolescent; Adult; Aged; Angiography - methods; Arteriovenous Malformations - surgery; Blood Loss, Surgical - prevention & control; Child; Collagen - therapeutic use; Dentistry; Embolization, Therapeutic - methods; Enbucrilate - therapeutic use; Ethiodized Oil - therapeutic use; Female; Follow-Up Studies; Gelatin Sponge, Absorbable - therapeutic use; Hemostatics - therapeutic use; Humans; Jaw - blood supply; Male; Middle Aged; Minimally Invasive Surgical Procedures - methods; Oral Surgical Procedures - methods; Patient Safety; Punctures - methods; Radiology, Interventional - methods; Retrospective Studies; Sclerosing Solutions - therapeutic use; Sclerotherapy - methods; Surgery; Young Adult
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2015.10.012

Purpose This case series describes patients with head and neck arteriovenous malformations who underwent oral and maxillofacial surgical procedures combined with interventional radiology techniques to minimize blood loss. Materials and Methods Twelve patients underwent femoral cerebral angiography to visualize the extent of vascular malformation. Before the surgical procedures, surgical sites were devascularized by direct injection of hemostatic or embolic agents. Direct puncture sclerotherapy at the base of surgical sites was performed using Surgiflo or n-butylcyanoacrylate glue. Surgical procedures were carried out in routine fashion. A hemostatic packing of FloSeal, Gelfoam, and Avitene was adapted to the surgical sites. Results Direct puncture sclerotherapy with Surgiflo or n-butylcyanoacrylate glue resulted in minimal blood loss intraoperatively. Local application of the FloSeal, Gelfoam, and Avitene packing sustained hemostasis and produced excellent healing postoperatively. Conclusion Patients with arteriovenous malformations can safely undergo routine oral and maxillofacial surgical procedures with minimal blood loss when appropriate endovascular techniques and local hemostatic measures are used by the interventional radiologist and oral and maxillofacial surgeon.