[Comparison of efficacy between ultrasound-guided microwave ablation and sclerosing agents for the treatment of head and neck venous malformations].

Objective: To compare the efficacy of ultrasound-guided microwave ablation and sclerosing agents in the treatment of head and neck venous malformations. Methods: Patients with head and neck venous malformations treated by ultrasound guidance at Sichuan Cancer Hospital were retrospectively enrolled from August 2019 to May 2024. The patients were divided into the ablation group and the sclerotherapy group according to different treatment methods, and the lesion volume reduction rate (VRR), efficacy evaluation, number of treatments, cosmetic grading score (CGS), pain numerical rating scale (NRS), patient satisfaction and postoperative complications were compared between the two groups before the surgery and at the last follow-up after the surgery. Follow-up was conducted every 3 months after surgery until there was no significant change in the lesion for half a year and the patient had no other discomfort. Results: A total of 76 patients including 20 males and 56 females were enrolled, with a mean age of (35.4±17.6) years. There were 34 patients (11 males and 23 females) in the ablation group, with a mean age of (36.6±18.3) years and 37 lesions. Fourty-two patients (9 males and 33 females) were in the sclerotherapy group, with a mean age of (34.4±17.2) years and 45 lesions. The follow-up time of the ablation group and sclerotherapy group was (12.3±0.7) months and (12.0±0.5) months, respectively. The number of treatments in the ablation group was less than that in the sclerotherapy group [(1.1±0.2) vs (3.1±1.0), P<0.05]. There were no significant differences in VRR, efficacy evaluation, CGS score, NRS score, and satisfaction score between the two groups (all P>0.05). The volume of lesions in both the ablation group and the sclerotherapy group was reduced at the last follow-up after the surgery compared with that before the surgery [ablation group: 3.7 (1.6, 15.2) vs 0.7 (0.2, 2.5) cm3, sclerotherapy group: 5.3 (0.6, 11.0) vs 0.5 (0.1, 3.3) cm3], and the CGS score and NRS score were lower than those before surgery [ ablation group: (3.9±0.3) vs (1.4±0.7), (4.9±0.8) vs (1.1±0.9), sclerotherapy group: (3.9±0.3) vs (1.2±0.5), (5.0±0.7) vs (1.2±1.0)] (all P<0.05). None of the patients in either group developed serious complications. Conclusion: Ultrasound-guided microwave ablation is safe and effective in the treatment of head and neck venous malformations, and can reduce the number of treatments compared with conventional sclerotherapy.