How to treat oral and maxillofacial arteriovenous malformations?

  Classification: 1. Soft tissue arteriovenous malformation: used to be called “trapezoid hemangioma” and “arteriovenous fistula”; 2. Bone tissue arteriovenous malformation: used to be called “central hemangioma of the jaws”.  It should be emphasized that: 1. interventional embolization is the preferred treatment modality 2. ligation of the external carotid artery and its branches, or embolization with spring coils or silk wires in the blood supply artery are strictly prohibited. The main purpose of embolization is to control the lesion development and bleeding, and the key is to eliminate the abnormal vascular mass with liquid embolization agent. Commonly used liquid embolization agents: anhydrous ethanol and n-butyl dicyanoacrylate (NBCA).  Treatment modality: 1. Soft tissue arteriovenous malformation: divided into diffuse type, focal type and arteriovenous fistula. Preoperative embolization + radical surgery can be used to achieve cure.  2.High-flow intra-maxillary vascular malformation: divided into arteriovenous malformation and arteriovenous malformation. Dual intervention method: direct puncture of the superior and inferior alveolar artery plus venous pool (arteriovenous malformation forbidden) Materials: (1) first release the metal spiral ring with coagulated cotton cilia in the lesion (to reduce the flow rate).  (2) Embolization with anhydrous ethanol by intravascular or local puncture. Cure can be achieved.