[Diagnosis and treatment of high-flow vascular malformation of the jaws].

OBJECTIVE

To report our experience on diagnosis and treatment of the high-flow vascular malformation of the jaws.

METHODS

Thirty-seven cases of high-flow vascular malformation of the jaws (6 cases in maxilla and 31 in mandible) were comprised this study. Twenty-one patients were embolized with coils and N-buty1-2-cyanoacrylate, and 16 cases underwent surgery. The embolization was carried out with both arterial and venous route.

RESULTS

Different signs of the lesions were demonstrated on X-ray plain film, such as locular, rough of bone trabecula and soap bubble-like changes, frequently accompanied by dilatation of the mandibular nerve canal. CT scan showed unilocular and multilocular radiolucency. T(1)WI and T(2)WI on MRI exhibited low signal, and varix was found on DSA. The high-flow vascular malformation of the jaws classified into two groups: arterial malformation and arteriovenous malformation according to CT and DSA. The acute bleeding of 16 cases was effectively controlled by embolization. The chronic bleeding in the other 5 cases stopped after the 4 - 59 months and new bone formation was found in the follow-up radiography.

CONCLUSIONS

The characteristic signs were not unique on X-ray plain film, and MRI and DSA had diagnostic value. Arteriovenous malformation of the jaws should be embolized by direct puncture in conjunction with endovascular therapy, and arterial malformation be superselectively embolized with NBCA.