Percutaneous Sclerotherapy of Venous Malformations of the Head and Neck Using Sodium Tetradecyl Sulphate (Sotradecol)

Abstract

Thirty-eight patients with venous malformations of the face, neck, and tongue underwent percutaneous sclerotherapy with direct puncture and instillation of sodium tetradecyl sulphate (Sotradecol) (33-67% solution, mixed with contrast material) into the lesions. Each patient underwent from one to seven treatment sessions (mean 2.2), followed by reconstructive surgery in three cases. Of the 34 patients who responded to the follow-up questionnaire, the late results were excellent or good in 23 patients (68%), moderate in eight, unchanged in three, and were worse in one. Compared with our previous experience of embolisation of such malformations with ethanol, the results with Sotradecol were slightly worse. There was one serious complication, unilateral loss of vision in a patient with a large malformation that extended to the orbit. In conclusion, percutaneous sclerotherapy with Sotradecol is effective treatment for venous malformations of the head and neck. Careful planning is essential to reduce the risks of the treatment.

The Use of Sodium Tetradecyl Sulphate for the Treatment of Venous Malformations of the Head and Neck

“…In this series, no serious complications occurred such facial nerve palsy [8] and blindness [7] which have been reported by others. Post injection inflammatory reactions and pain were recorded in all patients.…”

“…Although the serendipitous discovery of the therapeutic efficacy of propranolol in the management of infantile hemangiomas has revolutionized the care and outcomes of these lesions [5,6], there is no standard treatment protocol for the management of VM. Treatment options of low flow VM include simple observation, minimally invasive interventions such as sclerotherapy or embolization [7,8], laser ablation [9], cryotherapy [10], or more aggressive surgical resection. Management of these lesions varies according to the patient's age, size of the lesion, location, type of the lesion, as well as surgeon experience.…”

Comparative Analysis of Intralesional Sclerotherapy with Sodium Tetradecyl Sulfate Versus Bleomycin in the Management of Low Flow Craniofacial Soft Tissue Vascular Lesions

“…Reports have been published on the safe and effective use of ethanol for the treatment of venous malformations [15,16]. Ethanol is inexpensive and easy to administer.…”

Treatment of a Large Pharyngeal Venous Malformation using Transoral Sclerotherapy

“…Although pure ethanol is a very effective sclerosant used to treat VM, the potential for nerve injury in ethanol sclerotherapy can be a significant problem [6,7]. We discussed the risks of ethanol sclerotherapy for pharyngeal VM and concluded that this was not the preferred method for initial intervention in our patient.…”