Background: Arteriovenous malformations (AVMs) are
composed of an abnormal communication between arterial
and venous channels without intervening capillary bed. In the
face, they commonly present with asymmetry, bleeding, tooth
mobility and headache. The most successful treatment to date
is embolization followed by surgical excision.
Objectives: To evaluate the safety and efficacy of embolization
followed by surgical reconstruction in the treatment
of extensive facial AVMs.
Patients and Methods: In this study we present the outcome
of treatment of 25 patients presented with extensive facial
AVMs and admitted in the department of plastic and reconstructive
surgery at Tanta University Hospital in the period
from January 2016 to July 2021. Our treatment strategy was
embolization guided by digital subtraction angiography followed
by surgical excision.
Results: Twelve patients had one anatomic facial subunit
affected by the lesion while nine cases had two subunits
affected and four patients had 3 subunits affected. The average
length of the widest dimension of the lesion was 6cm. Most
of our cases (19 of 25) were in Schobinger stage 2 at the
initial presentation. All our patients were followed for at least
1 year and none of them showed any evidence of recurrence
of the lesion during the follow-up period. All our cases had
controlled disease.
Conclusion: Preoperative embolization followed by surgical
excision is the ideal treatment for extensive AVMs of
the face.