Angiodysplasias of the head and neck: present-day principles of treatment using elements of plastic surgery

Dan V.N., Sapelkin S.V., Sharobaro V.I., Timina I.E., Tsygankov V.N., Karmazanovskiy G.G., Subbotin V.V., Vafina G.R.

Department of Vascular Surgery, A.V. Vishnevsky Institute of Surgery under the RF Ministry of Public Health, Moscow, Russia

The authors assessed the outcomes of treatment of fifty-one patients presenting with angiodysplasias of the head and neck. Of these, 24 patients suffered from the venous form and 27 had the arteriovenous form. The 51 patients accounted for 23.5% of the total number of patients with congenital vascular malformations over a five-year period. The topicity and angioarchitectonics of the lesion were specified by means of the standard diagnostic complex (i. e., duplex scanning of the vessels, ultrasonographic study of the soft tissues and osseous structures, computed and magnetic resonance tomography, echocardiography, and angiography).

Radical excision of the angiomatous tissues was performed in 15 patients and palliative one – in 36 cases. Eight patients were subjected to stagewise resection interventions, ten patients underwent stagewise sessions of laser coagulation, and seven patients endured stagewise roentgenoendovascular embolisations of the afferent arteries. Two patients with the venous form were postoperatively subjected to sessions of sclerotherapy of the residual venous caverns.

Two patients in the remote period (7–10 days) underwent autodermoplasty with a free perforated cutaneous flap. This technique was used while closing the wound surface after removing the angiomatous tissues of the parotid region and hairy portion of the head. In five patients the wound surface was closed with a mobilized cervical fat-cutaneous flap.

Taking into consideration the importance of the cosmetic outcome after excising the angiomatous tissues on the face and neck, it is necessary to seek for wide application of plastic methods of closing the wound. These methods simultaneously allow of making operative interventions for angiodysplasias more radical.

KEY WORDS: angiodysplasia, sclerotherapy, resection interventions, plasty of the wound surface, mobilized fat-cutaneous flap.

P. 142

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