Arteriovenous Malformation in Mandible

Malformasi arteriovenosa (AVM) adalah malformasi vaskular yang ditandai dengan anomali komunikasi antara arteri dan vena tanpa melibatkan kapiler yang normal. AVM mandibula merupakan kondisi yang sangat jarang terjadi. Namun dapat menimbulkan komplikasi serius jika tidak ditatalaksana dengan baik. Lima puluh persen dari semua AVM intraosseous terjadi di daerah maksilofasial dan sangat jarang terjadi pada mandibula. Seorang pasien perempuan, 20 tahun datang ke Poliklinik Bedah Plastik Rumah Sakit Universitas Andalas karena terdapat Benjolan pada bibir kanan semenjak 10 bulan yang lalu, riwayat bengkak disadari sejak umur 5 tahun, sudah tiga kali dilakukan operasi pada tahun 2010, 2015 dan 2017 di Rumah Sakit Umum Daerah Sawahlunto dan M.Djamil Padang, berupa operasi reduksi. Pada pemeriksaan fisik, kami dapatkan di regio mandibula dextra terdapat benjolan sewarna kulit, kebiruan, compessible, dan tidak ada denyut. Berdasarkan anamnesis dan hasil pemeriksaan fisik kami tegakkan diagnosis dengan malformasi arterivenosus pada regio mandibula dextra. Kami rencanakan untuk dilakukan injeksi sklerotik agent dan eksisi atau reduksi. Hasil satu hari setelah dilakukan tindakan injeksi sklerotik agent tampak bengkak sekitar bibir, bibir, pipi, dan wajah, pada daerah sekitar bibir berwarna kemerahan,dan disekitar dagu sebelah kanan berwarnna kebiruan, rasa nyeri dan tidak ada perdarahan.

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“…6 Penatalaksanaan dan terapi dari AVM di daerah maksilofasial sulit karena melimpah jaringan vaskular. 5,9…”

Section: Pendahuluanunclassified

Diagnosis dan Tatalaksana Malformasi Arterivenosus

Fory

Hardianti

2022

Scientificj

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“…AVMs occur as a result of errors of vascular morphogenesis that is always present at birth, grow proportionally with the child, and may evident at any time during life due to an events such as trauma, surgery, and infection. [ 4 5 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 6 ] The management and the therapy of this condition in the maxillofacial region are difficult because of the abundant vascular network. [ 5 9 ]…”

Section: Introductionmentioning

confidence: 99%

Great radiologic imitators: Arteriovenous malformation of mandible – A case series

et al. 2018

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“…Approximately 50% of arteriovenous malformations (AVM) occur in the head and neck 1 region and about 50% of intraosseous AVM are also found in this region 2 . AVM of the maxillomandibular region is a rare disease [3][4][5][6][7][8][9][10] but can be potentially life-threatening due to massive dental hemorrhage 3,4,6,7,[9][10][11] . Almost all patients presenting with AVM are children or adolescents 3,4,6,7,[9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Life-Threatening Arteriovenous Malformation of the Maxillomandibular Region and Treatment Outcomes

et al. 2012

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We report on cases of life-threatening maxillomandibular arteriovenous malformations (AVM) whereby patients had successful endovascular treatment with good outcomes. Out of a total 93 facial AVMs treated endovascularly between 1991 and 2009, five patients (5.4%) had maxillomandibular AVMs. All presented with uncontrolled dental bleeding. Endovascular procedure was the primary treatment of choice in all cases, either transfemoral approach with arterial feeder embolization or transosseous puncture, depending on the accessible route in each patient. NBCA (glue) was the only embolic agent used. Tooth extraction and dental care were performed after bleeding was controlled. All five patients (8–18 years) with a mean age of 12.4 years presented with massive dental bleeding following loosening of teeth, dental extraction and/or cheek trauma. The plain films and CT scans of four patients with AVMs of mandibles and one of maxilla, revealed expansile osteolytic lesions. The mean follow-up period was 6.6 years (ranging between one and 19 years). Three cases developed recurrent bleeding between two weeks to three months after first embolization, resulting from residual AVM and infection. Late complications occurred in two patients from chronic localized infection and osteonecrosis, which were successfully eradicated with antibiotic therapy and bony curettage. Complications occurring in two patients which included soft tissue infection, osteomyelitis and osteonecrosis were successfully treated with antibiotics, curettage and bone resection. No patient had a recurrence of bleeding after the disease had cured Initial glue embolization is recommended as the effective treatment of dental AVMs for emergent bleeding control, with the aim to complete eradicate the intraosseous venous pouches either by means of transarterial superselection or direct transosseous puncture. Patient care by a multidisciplinary team approach is important for sustained treatment results.

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Arteriovenous Malformation in Mandible

Cited by 5 publications

References 10 publications

Diagnosis dan Tatalaksana Malformasi Arterivenosus

Diagnosis dan Tatalaksana Malformasi Arterivenosus

Great radiologic imitators: Arteriovenous malformation of mandible – A case series

Life-Threatening Arteriovenous Malformation of the Maxillomandibular Region and Treatment Outcomes

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