Arteriovenous malformation of the external ear: a clinical assessment with a scoping review of the literature

Kim, Shin Hye; Han, Seung Hoon; Song, Yoon‐Jae; Park, Chang Sik; Song, Jae-Jin

doi:10.1016/j.bjorl.2016.09.004

Cited by 17 publications

(22 citation statements)

References 17 publications

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“…Ear AVMs have low incidence, and few reports in the literature have defined guidelines for its management . Treatment should be focused on the extent of resection.…”

Section: Discussionmentioning

confidence: 99%

Management of arteriovenous malformation of the ear: A protocol for resection and reconstruction

et al. 2019

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Objective: Arteriovenous malformations (AVM) of the ear show unique features. Progressive growth or inadequate management of AVMs may lead to bleeding, infection, cartilage exposure, and ultimately loss of structure. Total ear amputation is an alternative; however, due to the structural complexity of the ear, reconstruction is technically challenging. This study presents a treatment algorithm based on a clinical series, with treatment options including resection and immediate and late reconstruction.Methods: Between 2004 and 2018, 12 patients with auricular AVMs were treated with AVM resection and ear reconstruction at our hospital. Among these 12 patients, seven were women, and patients' ages ranged between 4 and 34 years. Parameters considered before resection and reconstruction were compromised ear extension (partial, total, or extra-auricular involvement), thickness (cutaneous and cartilaginous), symptoms (bleeding, infection, ulceration, and/or cartilage exposure), and preoperative embolization. Total resection of AVMs was planned as the first step in all cases, followed by primary closure. AVM resection was categorized into a partial or total procedure, resulting in partial or total ear defects. Reconstruction was categorized as immediate or delayed.Results: Preoperative embolization was performed in 10 patients. AVMs were totally removed, resulting in seven total ear amputations. In six of these patients, total ear reconstruction was performed 6 months later, and all patients were recurrence-free. Only one patient did not undergo ear reconstruction. Regrowth was not observed in any reconstructed ear.Conclusion: Treatment of ear AVMs requires a planned approach to achieve favorable clinical outcomes and for concomitant safe and definitive reconstruction.

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“…Ear AVMs have low incidence, and few reports in the literature have defined guidelines for its management . Treatment should be focused on the extent of resection.…”

Section: Discussionmentioning

confidence: 99%

Management of arteriovenous malformation of the ear: A protocol for resection and reconstruction

et al. 2019

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“…This makes clinical diagnosis quite straightforward, although this is not always the case as reports of initial misdiagnosis have been noted. This was the case in our patient who was initially diagnosed and managed for Auricular Haemangioma at the source of referral [3]. Diagnostic and interventional radiological procedures make management of AVM less difficult.…”

Section: Discussionmentioning

confidence: 62%

Challenges of Management of Arteriovenous Malformation of the Pinna in a Low Resource Setting: A Case Report

Adeagbo¹,

Daniel²,

Ogunkeyede³

et al. 2020

CRCM

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Arteriovenous Malformation (AVM) is a lesion of vascular development characterized by an abnormal communication between an artery and a vein without an intervening capillary bed. AVM of the pinna is very rare with very few reported cases in Africa. Management of an AVM is often daunting, most especially in a resource challenged centre like ours where facilities for super selective embolization are not available. We present the case of a 17-year-old female with a pulsatile swelling of the left pinna since childhood. Clinical and radiological diagnosis of arteriovenous malformation was made. She was managed surgically with left external carotid artery ligation, partial auricular resection and postauricular scalp rotation flap cover of the cartilage remnant. The aetiopathogenesis, clinical presentation, diagnostic confirmation and treatment options are discussed. We also discuss the challenges of managing AVM in poor resource settings like ours.

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“…It has been reported that 50% of the head and neck AVMs affect the oral and maxillofacial region [4 , 7] . In a retrospective review of 81 patients with an AVM of the head and neck, Kim et al reported that cheek was the most common site (31%) followed by ear (16%) [11] . Race or sex predilection has not been demonstrated, [5 , 12] although Spreafico et al have reported a male:female ratio of 1:1.5 [13] .…”

Section: Epidemiologymentioning

confidence: 99%

Management of extracranial arteriovenous malformations of the head and neck

et al. 2020

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The purpose of this study was to review the outcomes of the different therapies for extracranial head and neck arteriovenous malformations (AVMs).AVMs are high-flow congenital vascular anomalies. They are composed of a complex system of vessels directly connecting feeding arteries to draining veins forming a nidus.They may be potentially life-threatening due to progressive symptoms and infiltrative disease. Extracranial AVMs most commonly affect the head and neck area (47.4%) followed by the extremities (28.5%). AVMs are best characterized as being either focal or diffuse. Focal AVMs have good outcomes following adequate treatment. Diffuse lesions have multiple feeding vessel, which results in high rates of recurrence despite treatment.The management of AVMs includes conventional surgery and endovascular techniques. A combination of embolization and surgical resection has become the treatment of choice over the last years. The main goal of both forms of treatment being the complete blockage or resection of the nidus. Transcatheter embolization of vessels has evolved over the years and new embolic agents have emerged. The types of materials available for embolization are classified into mechanical devices, liquid agents and particulates. Efficacy, rate of recurrence and most common complications were evaluated.AVMs recurrence after embolization or resection is reported in up to 80% of cases. Incomplete resection and embolization can induce aggressive growth of the remaining nidus and the risk of progression is up to 50% within the first 5 years and recurrences can occur up to 10 years later.✩ This article was written by members and invitees of the International Head and Neck Scientific Group ( www.IHNSG.com).

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Arteriovenous malformation of the external ear: a clinical assessment with a scoping review of the literature

Cited by 17 publications

References 17 publications

Management of arteriovenous malformation of the ear: A protocol for resection and reconstruction

Management of arteriovenous malformation of the ear: A protocol for resection and reconstruction

Challenges of Management of Arteriovenous Malformation of the Pinna in a Low Resource Setting: A Case Report

Management of extracranial arteriovenous malformations of the head and neck

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