Sclerotherapy With Polidocanol for Head and Neck Vascular Anomalies: A Single-Center Experience

To evaluate the efficacy and safety of percutaneous sclerotherapy with polidocanol in head and neck vascular anomalies, including hemangiomas, venous malformations, and venolymphatic malformations.

This retrospective study included 14 patients (6 females, 8 males; median age 25.5 years, range 2-60) treated between August 2020 and November 2022. Lesion types were confirmed by magnetic resonance imaging (MRI) and ultrasound, and all underwent percutaneous sclerotherapy with polidocanol under ultrasound and fluoroscopic guidance. Outcomes were assessed using pre- and post-treatment MRI volumetry, clinical evaluation, and complication monitoring.

A total of 27 sclerotherapy sessions were performed. The mean pre-treatment lesion volume was 11.19 ± 10.32 cm³, decreased to 4.89 ± 2.97 cm³ post-treatment, corresponding to a mean reduction of 56.3% (P < 0.001). Clinically, 35.7% of patients demonstrated excellent outcomes, while 64.3% showed moderate improvement. Hemangiomas responded especially well, often requiring fewer sessions. The most common adverse events that occurred were transient swelling (92.9%) and pain (85.7%), both of which resolved spontaneously. Minor adverse events were transient swelling (92.9%) and pain (85.7%), which resolved spontaneously. One patient developed localized necrosis that healed without sequelae. No systemic or severe complications occurred.

Polidocanol sclerotherapy is a safe and effective treatment option for low-flow vascular malformations of the head and neck, with substantial lesion volume reduction and minimal complications. Its efficacy in hemangiomas highlights a promising therapeutic avenue where limited prior evidence exists. Given its favorable safety profile compared to ethanol and other sclerosants, polidocanol should be considered particularly suitable for cosmetically and functionally sensitive head and neck lesions.