ABSTRACT
BACKGROUND AND OBJECTIVES: Arteriovenous malformation is a vascular malformation with fast-flow shunt from the artery to the vein. Extracranial arteriovenous malformation in the head and neck (HNAVM) is so rare that there have been no systematical reports related to it in Korea. Authors aimed to suggest the treatment protocols for HNAVM through retrospective analysis. SUBJECTS AND METHOD: We reviewed retrospectively the medical records of 19 patients with extracranial HNAVM, who had been diagnosed and treated between 1995 and 2001. Mean follow-up duration was 27.3 months. The mean age at detection was 13.2 years old. The cheek was the most frequently suffered site. We used MRI, angiography, and 99mTechnetium (Tc) RBC scintigraphy for the diagnosis and follow-up of HNAVM. For the treatment, ethanol sclerotherapy, excision, and embolization were adopted alone or in variable combination. RESULTS: Angiography was confirmative of the diagnosis and MRI was excellent in evaluating the extent of the disease. Ethanol sclerotherapy was used as the first line of treatment for 11 cases. For others, surgical excision combined with embolization was used as the first line of treatment for 7 patients and the second choice for 6 patients. 99mTc RBC scintigraphy was useful in quantifying the response after treatment. Fifteen out of 19 patients finally achieved 75% or more reduction in their size of lesions. There were 5 permanent complications from the total of 37 procedures. CONCLUSION: For those cases of HNAVM that had the nidus accessible via the percutaneous route, ethanol sclerotherapy worked as the first-line treatment. For other HNAVM cases, surgical excision with embolization might be the best choice of treatment.