Monoethanolamine oleate sclerotherapy for the treatment of intraoral vascular anomalies: retrospective study and suggestion for a clinical guideline.

Vascular anomalies are common in the head and neck, and oral lesions are most commonly found on the lips, tongue, mucosa, and palate. Monoethanolamine oleate sclerotherapy (MOS) is an option for treatment, although we know of no established protocols yet. We report the prevalence and characteristics of intraoral vascular anomalies (IVA) and the results achieved with the use of 5% MOS, and suggest a clinical guideline. Data from the medical records of patients with IVA were collected (age, sex, ethnicity, site, size, duration, and treatment). Cases treated with MOS were detailed, and data about number of applications, interval between them, dose, adverse effects, and results were recorded. A total of 65 cases of IVA were found. White-skinned women aged from 61 to 70 years (n=21) were most likely to be affected, and the lower lip (n=25) was the most common site. Twenty-seven were treated with MOS using a mean of 1-2 applications with a seven-day interval. The mean dose applied was 0.3ml/section, which was diluted in local anaesthetic in 38 cases. Twenty-two resolved completely. In summary, we found a prevalence of 4.8% of IVA and European women aged 61 to 70 years were most affected. MOS 5% was effective and safe in the treatment of IVA more than 3cm in size, with minimal morbidity and adverse effects. We therefore suggest a sclerotherapy protocol of 0.3ml of the drug (undiluted with anaesthetic) for each 1cm lesion (maximum 3cm), with weekly revaluations and further applications when necessary within a 14-day period.