Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-12-01T00:02:48.109Z Has data issue: false hasContentIssue false

Embolisation of an extensive arteriovenous malformation of the temporal region as an alternate treatment: case report

Published online by Cambridge University Press:  08 March 2017

S Aslan*
Affiliation:
Department of Otorhinolaryngology, Baskent University, Ankara, Turkey
H Yavuz
Affiliation:
Department of Otorhinolaryngology, Baskent University, Ankara, Turkey
A C Cagici
Affiliation:
Department of Otorhinolaryngology, Baskent University, Ankara, Turkey
O Kizilkilic
Affiliation:
Radiology, Faculty of Medicine, Baskent University, Ankara, Turkey
*
Address for correspondence: Dr Sundus Aslan, Cemalpasa Mh 10 Sk, Elife Hn Apt no 8/10, 01140 Seyhan-Adana, Turkey. Fax: +90 312 447 22 73 E-mail: [email protected]

Abstract

Objectives:

To report the case of a spontaneous arteriovenous malformation involving the auricula, external auditory meatus, middle ear and part of the petrous apex, and also to provide updated information about its management.

Case report:

A 33-year-old woman presented complaining of accelerated growth of a retro-auricular swelling during her latest pregnancy, together with pain, pulsatile tinnitus and ear discharge. An arteriovenous malformation occupying the right auricula, external auditory canal, mastoid proccess of the temporal bone and the lateral half of the petrous segment was diagnosed, using temporal computerised tomography and magnetic resonance imaging. The lesion was embolised with polyvinyl alcohol particles at angiography. Excision of the arteriovenous malformation nidus was performed. Three years post-operatively, magnetic resonance imaging showed no residual lesion or recurrence at the temporal bone and petrous apex, although a few scanty, serpiginous, vascular remnants had persisted.

Conclusions:

In the head and neck, arteriovenous malformations usually occur intracranially; they are rare outside the cranium. To our knowledge, there have been no previously published cases of such an extensive arteriovenous malformation involving the temporal region. Apropos of our case, the definition, clinical findings, diagnostic approaches and therapeutic management of arteriovenous malformations are discussed.

Type
Clinical Record
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 McGill, TJI, Mulliken, JB. Vascular anomalies of the head and neck. In: Cummings, CW, Fredrickson, JM, Harker, LA, Krause, CJ, Schuller, DE, eds. Otolaryngology-Head and Neck Surgery, 2nd edn. St Louis: Mosby-Year Book, 1993;333–46Google Scholar
2 Wu, JK, Bisdorff, A, Gelbert, F, Enjolras, O, Burrows, PE, Mulliken, JB. Auricular arteriovenous malformation: evalution, management, and outcome. Plast Reconstr Surg 2005;115:985–95CrossRefGoogle Scholar
3 Kohout, MP, Hansen, M, Piribaz, JJ, Mulliken, JB. Arteriovenous malformations of the head and neck: natural history and management. Plast Reconstr Surg 1998;102:643–54CrossRefGoogle ScholarPubMed
4 Yoshida, Y, Ishizawa, T, Mitsuhashi, Y, Kondo, S, Ohta, N, Sakai, N. A patient with subaural arteriovenous malformation complicated by macrotia. Clin Exp Dermatol 2005;31:151–2CrossRefGoogle Scholar
5 Bapuraj, JR, Bilwani, R, Khandelwal, N, Gupta, AK, Nehru, VI, Suri, S. Pre-operative embolization of auricular arteriovenous fistula. J Laryngol Otol 2002;116:42–5CrossRefGoogle ScholarPubMed
6 Lee, BB, Do, YS, Yakes, W, Kim, DI, Mattasi, R, Hyon, WS. Management of arteriovenous malformations: a multidisciplinary approach. J Vasc Surg 2004;39:590600CrossRefGoogle ScholarPubMed
7 Pham, TH, Wong, BJ, Allison, G. A large arteriovenous malformation of the external ear in an adult: report of a case and approach to management. Laryngoscope 2001;111:1390–4CrossRefGoogle Scholar
8 Raghu, M, De, R, Higgins, N, Axon, P. Spontaneous arteriovenous malformation of the external auditory meatus. J Laryngol Otol 2004;118:912–13CrossRefGoogle ScholarPubMed
9 Shinohara, K, Yamashita, M, Sugimoto, K, Tsuji, T, Omori, K. Transcatheter arterial embolization of auricular arteriovenous malformation. Otolaryngol Head Neck Surg 2005;132:345–6CrossRefGoogle ScholarPubMed
10 Lee, BB, Kim, DI, Huh, S, Kim, HH, Choo, IW, Byun, HS et al. New experiences with absolute ethanol sclerotherapy in the management of a complex form of congenital venous malformation. J Vasc Surg 2001;33:764–72CrossRefGoogle ScholarPubMed
11 Lee, BB, Do, YS, Byun, HS, Choo, IW, Kim, DI, Huh, SH. Advanced management of venous malformation with ethanol sclerotherapy: mid-term results. J Vasc Surg 2003;37:533–8CrossRefGoogle ScholarPubMed
12 Vinson, AM, Rohrer, DG, Wilcox, CW, Sigfred, SV, Wheeler, JB, Jacobs, JS et al. Absolute ethanol embolization for peripheral for arberiovenous malformation: report of two curses. South Med J 1988;81:1052–5CrossRefGoogle Scholar
13 Yakes, WF, Rossi, P, Odink, H. How I do it: Arteriovenous malformation management. Cardiovasc Intervent Radiol 1996;19:6571CrossRefGoogle Scholar