phenylephrine-hydrochloride and Vascular-Malformations

Topics: Aged, 80 and over; Embolization, Therapeutic; Enbucrilate; Epistaxis; Humans; Male; Nose; Telangiectasia, Hereditary Hemorrhagic; Tissue Adhesives; Vascular Malformations

Endoscopic endonasal resection of orbital lesions is a safe and common approach. Nevertheless, medial orbital wall defects following the procedure are not routinely addressed, potentially leading to diplopia and enophthalmos. In this article, the authors propose a new technique for purely endoscopic endonasal reconstruction of orbital wall defects following endoscopic endonasal resection of orbital lesions.The patient, a 43-year-old male, suffering from right exophthalmos and diplopia due to a venous malformation of the right orbit underwent endoscopic endonasal resection of the mass. Excision was followed by immediate transnasal endoscopic reconstruction with a commercially available porous polyethylene mesh (Medpor).The postoperative course was uneventful. The patient did not report any residual orbital asymmetry or diplopia. No recurrence of the venous malformation, mesh infection, or reconstruction instability was reported during the follow-up.The authors believe that this new technique could spur head and neck surgeons in strategically rethinking their approach to orbital tumors, proposing reconstruction to patients on a routine basis, and developing even more reliable and manageable solutions.

Topics: Adult; Biocompatible Materials; Diplopia; Endoscopy; Humans; Male; Nose; Orbit; Plastic Surgery Procedures; Polyethylenes; Time Factors; Vascular Malformations

Venous malformations are usually asymptomatic and managed conservatively. Treatment, in the form of laser, sclerotherapy, or resection, is needed only if lesions present with symptoms or cosmetic deformity. The aim of this study was to find out how effective radiofrequency ablation was in patients with incomplete or unsatisfactory resolution of a venous malformation after an intralesional injection of bleomycin. During the 5 year period 2008-2012, we organised a prospective, clinical study at a tertiary care centre. Patients were selected from the outpatient department of the Lady Hardinge Medical College and associated hospitals, New Delhi, India. Five patients with venous malformations were treated by intralesional injection of bleomycin in a dose of 0.5U/kg body weight, which was repeated every 2 weeks for a total of 8 injections. They then had multiple intralesional radiofrequency ablation every 2 months until a satisfactory outcome was achieved. After the initial 8 doses the reduction in the size of the lesions was minimal (less than 50%). After 2-4 applications of radiofrequency ablation there was appreciable reduction in the size of the lesions (about 80%) with good functional and cosmetic outcomes. Radiofrequency ablation is an effective adjunct for patients with venous malformations of the head and neck that have not responded satisfactorily to intralesional injection of bleomycin. To our knowledge radiofrequency ablation after intralesional injection of bleomycin has not previously been described as a treatment for venous malformations.

Topics: Adolescent; Adult; Bleomycin; Catheter Ablation; Cheek; Child; Female; Follow-Up Studies; Humans; Injections, Intralesional; Male; Nose; Prospective Studies; Retreatment; Sclerosing Solutions; Sclerotherapy; Tongue; Treatment Outcome; Vascular Malformations

Topics: Angiography, Digital Subtraction; Child; Female; Humans; Magnetic Resonance Imaging; Nose; Radiography, Interventional; Sclerotherapy; Ultrasonography; Vascular Malformations

Massive vascular malformations of the nose cause serious cosmetic, functional and psychological problems. Generally, no single treatment modality to date has provided satisfactory results. Therefore, multidisciplinary treatment approaches are being standardised. In spite of standard multidisciplinary treatments, especially postoperative outcomes in massive nasal vascular malformation cases are often aesthetically and functionally unsatisfactory due to the unique characteristics of the nose. While several studies report on the management of facial vascular malformations using local and distant flaps, none is specific to the nasal region.. The present article describes the treatment of four patients with recurrent massive nasal vascular malformation (which invades more than two-thirds of the nose) using a combined-procedure approach involving preoperative superselective embolisation, extensive (en bloc) malformation resection and nasal reconstruction using a paramedian forehead flap. Patients were followed up for a mean of 19 months. Preoperative assessments included MR angiography, selective angiography and physical examination, including Doppler sonography. Preoperative superselective embolisation was then performed by a radiologist. On post-embolisation day 2, patients underwent en bloc resection and total nasal reconstruction with paramedian forehead flap hitherto overlooked in the treatment of nasal vascular malformation.. Satisfactory results were achieved in all four patients. Three patients suffered a high-flow malformation and one suffered a low-flow malformation. As confirmed by the radiologist, no recurrences were noted. Colour matching and nasal contouring were satisfactory in all cases. There were no major complications such as serious infection, recurrent ulceration, postoperative bleeding or flap failure. All patients responded positively.. The present novel treatment of massive vascular malformations of the nose using selective embolisation, en bloc resection and a paramedian forehead flap was successful. The findings indicate that this treatment of massive nasal vascular malformations leads to successful functional and aesthetic outcomes. The patients were followed up for an average of 2 years and ongoing follow-up is scheduled.

Topics: Adult; Aged; Embolization, Therapeutic; Female; Forehead; Humans; Male; Middle Aged; Nose; Plastic Surgery Procedures; Surgical Flaps; Vascular Malformations; Young Adult

Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.

Topics: Angiofibroma; Embolization, Therapeutic; Face; Head; Humans; Nasopharyngeal Neoplasms; Neck; Nose; Radiography; Vascular Malformations