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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2008 April;19(1):17-23
Head and neck hemangiomas: a case series
Merulla V. E. 1, Burlini D. 1, Rebuffini E. 1, Zollino I. 2, Carinci F. 2
1 Department of Maxillofacial Surgery Civil Hospital, Brescia, Italy
2 Deparment of Maxillofacial Surgery University of Ferrara, Ferrara, Italy
Aim. Vascular anomalies are a heterogeneous group of lesions which can affect artery, capillary, venous and lymphatic drainage. Two different entities exist: hemangiomas (HMs) and vascular malformations (VMs).
Methods. From September 2005 to November 2007, 21 patients affected by 26 HMs were treated at the Department of Maxillofacial Surgery of the Civil Hospital in Brescia, Italy. Corticosteroids were the first line of treatment, especially for complicated HMs. Sclerotherapy was the second line of treatment and was performed when surgery was not appropriate due to localization and the residual dimension of the HMs which may have determined poor esthetic and functional results. Surgery was used as the first line of treatment for localized superficial HMs in good surgical locations, for small and involuted lesions and as an end procedure to gain good esthetic and functional results.
Results. The surgical removal of the HM was the first line treatment in 3 out of 26 lesions and the clinical outcome was good. Twenty one HMs were immediately treated with corticosteroids, 19 by injection and 2 orally. Their regression was about 49% and only three of them had surgery after injections. One HM was treated with sclerotherapy and reduction was about 50%.
Conclusion. In conclusion, HM affects infants, has different facial locations and an unpredictable growth course. Precise diagnosis and strict monitoring are mandatory. Several therapeutic options are available, thus, management must be individualized and therapeutic risks weighed against potential benefits.