Objective:To find a reasonable treatment modal for management of oral and maxillofacial hemangiomas and vascular malformations according to different clinical types. Methods:Some new kinds of therapy for hemangiomas, ...Objective:To find a reasonable treatment modal for management of oral and maxillofacial hemangiomas and vascular malformations according to different clinical types. Methods:Some new kinds of therapy for hemangiomas, such as krypton laser PDT, surgical approach combined Nd:YAG laser irradiation, direct puncture and coil embolization and transcatheter arterial embolization combined one staged plastic surgery were used and evaluated. Results: Each type of hemangioma could be treated effectively by means of single or multi disciplinary methods. Conclusion: New therapeutic modal for different type of hemangiomas and vascular lesions are recommended.展开更多
Oral and maxillofacial hemangioma and vascular malformations account for 60% of all the lesions in the body and are still great challenges for clinicians because of their unknown etiology and difficulties in managemen...Oral and maxillofacial hemangioma and vascular malformations account for 60% of all the lesions in the body and are still great challenges for clinicians because of their unknown etiology and difficulties in management. Successful therapy of these lesions now requires cooperative or multidisciplinary approaches including surgical procedure, embolization through interventional radiology, sclerosing therapy, laser therapy,psychological support, and others. Different treatment modalities are mandatory for different primary sites, clinical types and stages. This paper summarized current comprehensive and sequential approaches to the management of oral and maxillofacial hemangioma and vascular anomalies based on the authors’ experiences and relevant literatures, emphasizing the importance of multidisciplinary approaches. Hopefully, with the unraveling of the causative factors of vascular anomalies, more effective and specific treatment will emerge for management of these lesions.展开更多
To predict the patency of the circle of Willis and cerebral ischemia during carotid artery surgery (ligation, resection, revascularization) is of utmost importance both for the surgeons and the patients. Many methods ...To predict the patency of the circle of Willis and cerebral ischemia during carotid artery surgery (ligation, resection, revascularization) is of utmost importance both for the surgeons and the patients. Many methods have been proposed in the literature as simple and accurate means of evaluating the adequacy of collateral hemispheric blood flow to compensate for a potentially resectable carotid artery, including Matas test, DSA, intraoperative measurement of stump pressure or back pressure, preoperative and intraoperative EEG monitoring, ocular plethysmograph (OPG), temporary balloon occlusion (TBO) alone or with single photon emission computerized tomography (SPECT), xenon-enhanced computed tomography cerebral blood flow (Xe/CT CBF), and transcranial color Doppler (TCD). However, there is no single method as accurate and reliable as expected till now. This paper evaluated the merits and flaws of each method. Our review and clinical studies showed that the combination of preoperative TBO and SPECT cerebral blood flow imaging significantly increases the safety of ICA /CCA resection, which can be used routinely to predict the patients’ tolerance for carotid artery sacrifice without developing neurologic deficits. Supported by Research Fund of the Ministry of Public Health (Grant No.96-1-340) and Sustentation Plan for Excellent Academic Leader of Shanghai Municipality (Grant No.96XD14013).展开更多
文摘Objective:To find a reasonable treatment modal for management of oral and maxillofacial hemangiomas and vascular malformations according to different clinical types. Methods:Some new kinds of therapy for hemangiomas, such as krypton laser PDT, surgical approach combined Nd:YAG laser irradiation, direct puncture and coil embolization and transcatheter arterial embolization combined one staged plastic surgery were used and evaluated. Results: Each type of hemangioma could be treated effectively by means of single or multi disciplinary methods. Conclusion: New therapeutic modal for different type of hemangiomas and vascular lesions are recommended.
文摘Oral and maxillofacial hemangioma and vascular malformations account for 60% of all the lesions in the body and are still great challenges for clinicians because of their unknown etiology and difficulties in management. Successful therapy of these lesions now requires cooperative or multidisciplinary approaches including surgical procedure, embolization through interventional radiology, sclerosing therapy, laser therapy,psychological support, and others. Different treatment modalities are mandatory for different primary sites, clinical types and stages. This paper summarized current comprehensive and sequential approaches to the management of oral and maxillofacial hemangioma and vascular anomalies based on the authors’ experiences and relevant literatures, emphasizing the importance of multidisciplinary approaches. Hopefully, with the unraveling of the causative factors of vascular anomalies, more effective and specific treatment will emerge for management of these lesions.
文摘To predict the patency of the circle of Willis and cerebral ischemia during carotid artery surgery (ligation, resection, revascularization) is of utmost importance both for the surgeons and the patients. Many methods have been proposed in the literature as simple and accurate means of evaluating the adequacy of collateral hemispheric blood flow to compensate for a potentially resectable carotid artery, including Matas test, DSA, intraoperative measurement of stump pressure or back pressure, preoperative and intraoperative EEG monitoring, ocular plethysmograph (OPG), temporary balloon occlusion (TBO) alone or with single photon emission computerized tomography (SPECT), xenon-enhanced computed tomography cerebral blood flow (Xe/CT CBF), and transcranial color Doppler (TCD). However, there is no single method as accurate and reliable as expected till now. This paper evaluated the merits and flaws of each method. Our review and clinical studies showed that the combination of preoperative TBO and SPECT cerebral blood flow imaging significantly increases the safety of ICA /CCA resection, which can be used routinely to predict the patients’ tolerance for carotid artery sacrifice without developing neurologic deficits. Supported by Research Fund of the Ministry of Public Health (Grant No.96-1-340) and Sustentation Plan for Excellent Academic Leader of Shanghai Municipality (Grant No.96XD14013).
