[Vascular malformation of the head and neck--diagnosis and treatment]

Vascular malformations are the most common anomalies appearing from birth to any adulthood. They are not clinically and morphologically homogenous group. They may occur at different place but most often in the subcutaneous or submucous space in the oral cavity, pharynx, the paranasal sinuses and nose. The aim of this study was to present the difficulties in diagnosis and treatment of head and neck vascular malformations in patients hospitalized in ENT Department University of Lodz from 2001 to 2006. From 17 patients with vascular malformations we choose four to careful evaluation. Two patients had neck vascular malformation, two had the paranasal and nose sinuses tumors. Presented lesions were categorized as "low-flow" vascular malformation. In two cases there was vascular and lymphatic malformation, deeply located in the neck. In two cases arisen in the nose and the paranasal sinuses, there were capillary and cavernous types. We pointed out the clinical signs and diagnostic problems in deep vascular tumors and bleeding risk concerning treatment procedure. Even a needle biopsy and radiological imagining did not confirm the preoperative diagnosis. CT and MRI is recommended to delineate the extend the lesion, and evaluation of its special anatomical location, surrounding arteries, vessels and important neck structure prior to surgery. In the paranasal and nose tumor CT could show bone destructions as well.

Surgical careful excision has been favorable in depth neck laying and extended paranasal and nose vascular malformation. Because of the risk of bleeding careful hemostasis are important challenges in the surgical removal, so embolization is preferred in some cases.