Successful treatment of posttraumatic arteriovenous malformation of the lower lip.

ABSTRACT

Arteriovenous malformations (AVMs) are most commonly reported in the brain. Head and neck AVMs are reported to occur in 0.1% of the general population. On the other hand, posttraumatic AVMs are quite rare. Traumatic AVMs are extremely rare in the head and neck and are mostly seen in the extremities. The management of such lesions may include selective embolization or surgical exploration with ligation. A 13-year-old male adolescent visited our hospital for lower lip swelling, which developed 5 years ago after a lower lip laceration. The AVM was expanded and was graded as stage II. It was fed by the mandibular branch of both facial arteries and drained to the posterior facial vein. The radiologic intervention department performed an embolization before the operation. The main operation was performed 12 days after the embolization. A well-demarcated AVM lesion was found in the oral mucosa and was totally excised under general anesthesia. The authors easily performed the operation owing to the embolization making the AVM definitely demarcated and firmly palpable. The lip closure was done carefully considering the lip contour. No sign of recurrence was seen during 6 months of follow-up. The excellent treatment result of the posttraumatic facial AVMs occurs largely because of a collaboration with the radiologic intervention department using the selective embolization.