Diagnosis and treatment of arteriole malformation in head and neck: a clinical summary of 48 cases

doi:10.19438/j.cjoms.2025.06.011

Abstract

Abstract: PURPOSE: Reddish erythemas in the head and neck region are often misdiagnosed as capillary malformations and treated with laser therapy, but the efficacy is poor. Enhanced CT and MRI examinations usually show no obvious abnormalities, while ultrasonic Doppler can detect enhanced arterial murmurs, and angiography reveals dense distribution of arterioles in the lesion. This study aimed to name and classify such occult vascular malformations, and summarize their diagnostic and treatment methods. METHODS: The clinical data of 48 patients with arteriole malformations in the head and neck admitted to Peking University School and Hospital of Stomatology from April 2012 to October 2021 were retrospectively analyzed. Their symptoms, signs, and auxiliary examination results were summarized, and the application effects of percutaneous puncture arteriolar embolization, vascular perfusion therapy, surgical treatment, and sclerotherapy were evaluated. RESULTS: Arteriole malformations could be classified into cutaneous type and mucosal type based on the location of onset, and into central type(type Ⅰ) and divergent type(type Ⅱ) based on the characteristics of the supplying vessels. The clinical manifestations of cutaneous arteriolar malformations were reddish erythemas on the skin, occasional spontaneous bleeding, and slightly increased or normal skin temperature; the mucosal type presented as papillary elevation with central micro-depression accompanied by bleeding. Abnormal arterial murmurs could be heard by ultrasonic Doppler, angiography showed dense arterioles, while CT/MRI were mostly negative. The treatment was mainly percutaneous puncture arteriolar embolization, assisted by perfusion, sclerotherapy or surgical resection. A 5-year follow-up showed that spontaneous bleeding and erythema subsided, abnormal arterial sounds disappeared, and complications included edema, ulcer, recurrence, etc., with significant overall good efficacy. CONCLUSIONS: Some reddish erythemas are occult arteriole malformations, easily confused with capillary malformations. Ultrasonic Doppler is an important differential tool. Individualized treatment regimens (such as embolization combined with perfusion) selected according to typing can effectively control the condition and reduce misdiagnosis and mistreatment.

Key words: Arteriole malformation, Vascular malformation, Vascular embolization, Vascular perfusion, Sclerotherapy

CLC Number:

R782.2

Luo Quanfeng. Diagnosis and treatment of arteriole malformation in head and neck: a clinical summary of 48 cases[J]. China Journal of Oral and Maxillofacial Surgery, 2025, 23(6): 608-612.

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