Foam and liquid Bleomycin in the Management of Venous Malformations in Head and Neck Region

Effect of Foam and liquid Bleomycin in the Management of Venous Malformations in Head and Neck Region. A Comparative Study

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Publication date: Available online 22 May 2019

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Hesham A. Helal, Nada A. Mahmoud

Abstract

Background

Many treatment options for venous malformations (VMs) have been documented in the literature but injection sclerotherapy has been considered a current mainstay for their treatment. We conducted this study to determine the efficacy and durability of injection of different forms of bleomycin sclerotherapy in the treatment of VMs in cervico-facial region

Patients and Methods

Thirty patients with clinically diagnosed venous malformations of the head and neck region, confirmed by magnetic resonance imaging, had been injected with bleomycin sclerosing material. They were divided into 2 groups according to the form of bleomycin injected; Group A: foam form was injected and Group B: liquid form was injected. Patients' data, anatomical sites, type and volume of the VM, number of injection sessions and the average dose of injected agents were documented and statistically compared between the 2 groups.

Results

MRI imaging showed a decline of more than 90% from the initial size of the lesions in 66.7% of the cases and considerable decline (60%-90%) in 33.3% of the cases. In group A the number of sessions and the amount of sclerosant material injected were lower than that in group B. The cumulative dose in the equal size lesions was lower in the foam form than in the liquid form.

Conclusion

We recommend using bleomycin in its foam form on a greater number of patients with larger venous malformations and in different sites as in this form the results are more promising than in the liquid form.

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