下颌骨动静脉畸形的手术治疗

Surgical treatment of arteriovenous malformations of the mandible

目的 探讨下颌骨动静脉畸形的治疗方法。方法 根据临床检查和血管造影确定畸形血管的血液供应 ,备术中结扎。采用颌下常规切口或口内升支前缘切口 ,暴露畸形血管的范围决定结扎血管的数量。去除颊侧骨皮质 ,刮除病变血管组织 ,如有松动牙可将其用单颌夹板固定。结果 2年后临床、X线和血管造影检查 ,下颌骨病变区完全骨化 ,没有复发 ,没有牙齿损伤 ,神经感觉恢复。结论 该手术方法可保留牙齿和下颌骨的连续性 。

Objective To evaluate the methods of treatment of arteriovenous malformations of the mandible .Methods Angiography and CT in mandible were suggestive of an arteriovenous malformation. The curettage of the lesions was performed after ligation of the homolateral inferior alveolar and facial arteries. Results The 24 monthes clinical and radiological follow-up revealed satisfactory condensation of the mandible with no signs of re volving teeth and the inferior alveolar nerve. No significant blood loss occurred during surgery.Conclusion We report a surgical technique to treat mandibular arteriovenous malformations, which permits ligation of the feeding vessels and provides access allowing for complete removal of the intraosseous lesion. At the same time it not only prevents facial deformity by preserving the mandibular bone and oral soft tissue, but also, and more importantly, may preserve the dentition as well.