Clinical study of sclerotherapy of maxillofacial venous malformation using absolute ethanol and pingyangmycin

The purpose of this study was to evaluate the outcomes of sclerotherapy of maxillofacial venous malformations by use of absolute ethanol and pingyangmycin (bleomycin A(5) hydrochloride).

We treated 23 consecutive patients with maxillofacial venous malformations by sclerotherapy with a combination of absolute ethanol and pingyangmycin under local anesthesia. The size of the lesions ranged from 2 cm x 2 cm to 12 cm x 10 cm. Venography showed the presence of large venous lakes. Venograms were obtained during the first procedure before and after injection of absolute ethanol (0.5-2.5 mL) to confirm the site of the nidus and assess the effect of sclerosis of the nidus and draining veins. Subsequently, 8 to 16 mg of pingyangmycin dissolved in 40 mL of saline solution was infused into the nidus by a dynamic infusion pump at a rate of 1 mL/min. If necessary, this procedure was repeated once in 2 or 4 weeks. The clinical outcomes and complications were evaluated.

The duration of follow-up ranged from 6 to 37 months, with a mean of 20.3 months. Only 1 procedure was required in 3 patients, and the procedure was required to be repeated twice in 9 patients, 3 times in 7, and 4 times in 4. All the patients were satisfied with the treatment results, and excellent clinical results were obtained in 9 patients. There was no skin necrosis or nerve damage.

Percutaneous sclerotherapy with the combined use of absolute ethanol and pingyangmycin is a safe and effective treatment for maxillofacial venous malformations.