Management of Palatal Vascular Malformation Using Absolute Ethanol Sclerotherapy

Abstract

Arteriovenous malformation is treated by variety of techniques over the years. Sclerotherapy is considered an effective and conservative technique for the treatment of benign vascular lesions and replaced the traditional role of surgical therapy, especially for the venous lesions that are surgically difficult or at inaccessible areas. Absolute ethanol was adopted as a new sclerosant agent for this complex form of venous defects to improve overall treatment results with acceptable morbidity and recurrence rates. Sclerotherapy has the advantage of no external scaring, low cost, and few complications in comparison to the surgical treatment.

Minimal Invasive Surgical Management of Familial Arteriovenous Malformation

“…Case Reports in Dentistry associated with the lesions and decided to undergo treatment for aesthetic reasons only. Management of AVMs has always posed a challenge among clinicians because of their unpredictable behavior and high recurrence rate [23,24]. Over the years, a plethora of approaches, including surgical excision, irradiation, electrocoagulation, cryotherapy, intravascular magnesium or copper needles, systemic corticosteroids, interferon-α, embolization, lasers, and sclerotherapy, has been tried for the management of these lesions.…”

“…Sclerotherapy causes minimal scarring and has relatively fewer complications as compared to surgical excision [ 32 ]. Many sclerosing agents, for example, 5% sodium morrhuate, 5% ethanolamine oleate, sodium phyllite, 1% polidocanol, sodium tetradecyl sulfate, quinine urethane, hypertonic saline, and absolute ethanol, alone or in combination, have been used with varying results [ 24 , 27 ].…”

Treatment of deep-seated palatal vascular malformations by bleomycin sclerotherapy

“…The case reported by El-Hakim incidentally also had the lesion on the right side. 5 The relatively posterior remote location of these malformations in the hard palate added with their increased vascularity makes surgical attempts at treatment perilous and improbable. Moreover, the deeper extensions of these lesions are prone to uncontrollable haemorrhage during surgical attempts at excision.…”

“…The sclerosant agents which have been used commonly are 5% sodium morrhuate, 2 hypertonic saline, 5% ethanolamine oleate, 3 sodium tetradecyl sulfate, sodium psylliate, quinine urethron, polidocanol foam, 4 and absolute ethanol. 5 All these sclerosing agents have their particular advantages and limitations.…”

Venous malformations: clinical diagnosis and treatment

“…Ethanol is believed to preferentially displace water molecules at the membrane surface, thereby penetrating the lipid bilayer and compromising the structural integrity of the cell membrane (44). This triggers necrosis and apoptosis of the treated tissue, inducing intravascular thrombosis and intense inflammatory response (45).…”