Giant complicated glosso-cervical arterio venous malformation managed with external carotid artery ligation and serial injection sclerotherapy: a case report and review of literature

Giant arterio venous malformation (AVM) of the tongue and floor of mouth are rare. They become life threatening when ignored by the patients. Treatment protocols are not well established. This report describes the treatment of a 35 years old female who presented to us with complains of swelling of tongue, floor of mouth and left sub mandibular region since 15 years causing dysphagia, and oral bleed since one day. Magnetic resonance Angiography revealed a giant AVM at the above site with dilated left external carotid artery (ECA) and left lingual artery. Patient underwent ECA ligation under general anaesthesia and serial injection sclerotherapy at the local site. After 3 months and 6 cycles of sclerotherapy, the patient had a satisfactory outcome. A detailed report with review of literature is presented.

Injection Snoreplasty-a Simple Way to Treat Habitual Snoring.

Aims: Injection snoreplasty was recently introduced as a safe, effective, and minimally invasive treatment for primary snoring. We assess the effectiveness of the treatment in our patients. Study Design: It was a prospective, non-randomised study on 54 patients with primary snoring. Place and Duration of Study: Study was done in the department of otolaryngology &head neck surgery at PGIMER, Chandigarh, India over 7 years between January 2004 and December 2010. Methodology: Patients were questioned about their symptoms; a detailed clinical and radiological examination was done in all patients. All the causes of snoring were ruled out. 1-3% sodium tetradecyl sulphate (STS) injection was administered in all patients in 1-3 sittings. Patients were assessed after 1, 3 and 6 months and their improvement was noted Results: There were 47 males and 7 females enrolled in our study with mean age as 47.6 years. The mean duration of snoring was 76.1 months. The average BMI of patients was 28.11. All the patients except 4 were initially injected 1% STS injection; the others were injected 3%. 11 patients were re-injected at 1 month and 4 had 2nd re-injection at 3 month follow up. The mean improvement in symptoms was 57.24%. The only side effect was pain which in majority of patients was mild. There was no correlation between BMI and percentage of improvement. Conclusion: Injection snoreplasty is a safe and cost effective treatment for primary snoring.