Arteriovenous malformation of the external ear: a clinical assessment with a scoping review of the literature <sup>☆</sup>  <span class="so-article-trans-title" dir="auto"> Translated title: Malformação arteriovenosa da orelha externa: avaliação clínica com revisão abrangente da literatura </span>

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ion was recorded. The postoperative follow-up duration varied from 1 month to 19 years, and only one case of unresectable, residual cervicofacial arteriovenous malformation was recorded.

Conclusion

Auricular arteriovenous malformation is a rarely encountered disease, but should be suspected if a patient presents with a swollen ear and pulsatile tinnitus. Appropriate imaging is essential for diagnosis and evaluation of the extent of disease. As embolization affords only relatively poor control, total surgical removal of the vascular mass is recommended.

Resumo

Introdução

Malformação Arteriovenosa Auricular da orelha externa é uma doença raramente observada, em particular, na região da aurícula, com hemorragia espontânea, tem sido infrequentemente relatada.

Objetivo

No presente estudo, relatamos um caso incomum de malformação arteriovenosa auricular de início tardio originária da artéria auricular posterior confirmada por angiotomografia computadorizada. O caso foi controlado com sucesso por embolização endovascular pré-cirúrgica seguida por excisão completa da lesão. Além disso, nós também apresentamos uma revisão abrangente da literatura.

Método

Um homem de 60 anos de idade com malformação arteriovenosa auricular direita tratado em nosso centro de atendimento terciário e 52 pacientes com malformação arteriovenosa auricular descritos em 10 relatos de casos e um estudo de revisão são apresentados. A malformação arteriovenosa auricular pode manifestar-se como inchaço da orelha, zumbido pulsátil, dor e/ou sangramento. Ao exame físico, um edema pulsátil e/ou uma massa sensível é evidente. Quando há suspeita de malformação arteriovenosa, as lesões devem ser visualizadas usando modalidades de imagem que detectam de maneira ideal as lesões vasculares, e tratadas por meio de embolização, excisão total da lesão, ou ressecção auricular. A eficácia dos vários métodos de diagnóstico utilizados e os desfechos do tratamento foram analisados.

Resultados

Várias modalidades de imagem, incluindo ultrassonografia Doppler, angiotomografia computadorizada, angiografia por ressonância magnética e/ou angiografia cerebral transfemoral foram usadas para diagnosticar 38 casos relatados na literatura. Em outros 15 casos, nenhuma imagem foi realizada; o tratamento foi determinado unicamente pelo exame f�

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Arteriovenous malformations of the head and neck: natural history and management.

Harald Hansen, J Mulliken, M Kohout … (1998)

This is a retrospective review of 81 patients with extracranial arteriovenous malformation of the head and neck who presented to the Vascular Anomalies Program in Boston over the last 20 years. This study focused on the natural history and effectiveness of treatment. The male to female ratio was 1:1.5. Arteriovenous malformations occur in anatomic patterns. Sixty-nine percent occurred in the midface, 14 percent in the upper third of the face, and 17 percent in the lower third. The most common sites were cheek (31 percent), ear (16 percent), nose (11 percent), and forehead (10 percent). A vascular anomaly was apparent at birth in 59 percent of patients (82 percent in men, 44 percent in women). Ten percent of patients noted onset in childhood, 10 percent in adolescence, and 21 percent in adulthood. Eight patients first noted the malformation at puberty, and six others experienced exacerbation during puberty. Fifteen women noted appearance or expansion of the malformation during pregnancy. Bony involvement occurred in 22 patients, most commonly in the maxilla and mandible. In seven patients, the bone was the primary site; in 15 other patients, the bone was involved secondarily. Arteriovenous malformations were categorized according to Schobinger clinical staging: 27 percent in stage I (quiescence), 38 percent in stage II (expansion), and 38 percent in stage III (destruction). There was a single patient with stage IV malformation (decompensation). Stage I lesions remained stable for long periods. Expansion (stage II) was usually followed by pain, bleeding, and ulceration (stage III). Once present, these symptoms and signs inevitably progressed until the malformation was resected. Resection margins were best determined intraoperatively by the bleeding pattern of the incised tissue and by Doppler. Subtotal excision or proximal ligation frequently resulted in rapid progression of the arteriovenous malformation. The overall cure rate was 60 percent, defined as radiographic absence of arteriovenous malformation. Cure rate for small malformations was 69 percent with excision only and 62 percent for extensive malformations with combined embolization-resection. The cure rate was 75 percent for stage I, 67 percent for stage II, and 48 percent for stage III malformations. Outcome was not affected significantly by age at treatment, sex, Schobinger stage, or treatment method. Mean follow-up was 4.6 years.

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Sinus Wall Resurfacing for Patients With Temporal Bone Venous Sinus Diverticulum and Ipsilateral Pulsatile Tinnitus.

Jae‐Jin Song, Young-Jin Kim, So Young Kim … (2015)

Pulsatile tinnitus (PT) caused by venous sinus diverticulum is a relatively common, potentially incapacitating condition. Although treatment via an external approach or endovascular coiling has been reported, much remains unknown about the possible pathophysiological mechanisms and appropriate management of PT.

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Author and article information

Contributors

Jae-Jin Song

Journal

Journal ID (nlm-ta): Braz J Otorhinolaryngol

Journal ID (iso-abbrev): Braz J Otorhinolaryngol

Title: Brazilian Journal of Otorhinolaryngology

Publisher: Elsevier

ISSN (Print): 1808-8694

ISSN (Electronic): 1808-8686

Publication date PMC-release: 17 October 2016

Publication date Collection: Nov-Dec 2017

Publication date (Electronic): 17 October 2016

Volume: 83

Issue: 6

Pages: 683-690

Affiliations

[a ]Korea University Medical Center, Korea University College of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, Republic of Korea

[b ]Seoul National University Bundang Hospital, Seoul National University College of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Seongnam, Republic of Korea

[c ]Seoul National University Bundang Hospital, Seoul National University College of Medicine, Department of Plastic Surgery, Seongnam, Republic of Korea

Author notes

[* ]Corresponding author. jjsong96@ 123456gmail.com

Article

Publisher Item ID: S1808-8694(16)30202-6

DOI: 10.1016/j.bjorl.2016.09.004

PMC ID: 9449233

PubMed ID: 28277225

SO-VID: 7ff2f651-400c-4a59-8859-f67f807391ee

License:

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

History

Date received : 20 May 2016

Date accepted : 20 September 2016

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