The Application Study Of STAE In The Therapy Of Maxillofacial Vessel Malformations

The vascular malformation in maxilloface used to be calledmaxillofacial hemangioma. It is caused by congital growth abnormality ofvessel and has the highest occurance among the benign maxillofacial tumor.About 60 percents of arterio-venous malformation in systemic regions takeplace in maxillface.The malformation presents as widely disease due to manyvasculars involvewd, The bones can be involved on above 1/3 pations. According to the formtheory and occoruence position, Waner and Suen improved Mulliken's pointabout the sort of maxillofacial vascular malformation by classifying themalformation into four categories:micro-venous malformation, venousmalformation, arterio-venous malformation, multiplex malformation. Themultiplex malformation is more popular than others. Comparing with the malformation in purtenance, the blood supply ofmaxillofacial vascular malformation is much more comlex .For most vascularmalformation ,the blood supply comes from the branches of the externalcarotid, the contra external carotid is usually the potentional blood supply.It isdifficult matter for both surgical and interventional therapy. The clinicalpratice has proved that the simple surgical therapy has many abuses such asdamaging the visage,loosing too much blood and reoccurance after operation.The surgical therapy can also make the blood supply of the malformation morecomplicated and increase the difficuity of subsequent interventional 31therapy.So that,the surgical therapy shoud not be choosed as the firsttreatment of maxillofacial vascular malformation. The non-surgical therapy applicated in clinical works includecirrhosistherapy,microweave therapy,Nd-YAG laser therapy and etc.They allhave own shortcomings and can be applicated in narrow scopes. On thecornary ,the TAE therapy has more adventages and applications. TAE hasbeen regarded as the first choice for the maxillofacial venous malformation. Itis also reasonable to deal with other kinds of malformation especiallyfor thosethat not suitable for surgical therapy.For the AVM with large area andcomplex blood supply, whether it is deep or shallow, STAE has surelyeffection and sometimes is even the only choice available. STAE beforesurgical therapy is also necessary . Traditional ligation of external carotid cannot reduce the blood losing in the operation, but STAE before surgicaltherapy can control the the blood lost in the surgical operation effectively andmake the opration area clear .The surgical operation will be easy to performand the final result will be more ideal. It is reported by Qi jianpin that theblood lost (200-300ml on average) in surgical operation after STAE is muchless than that in simple surgical operation (1500ml on average) . STAE in ECA is the main treatment of maxillofacial vascularmalformation. Because of its particular anatomiacal position , STAE inECA is much more dangerous than that in other organ .Most of STAE areperformed in the malformed hemal bed ,some of STAE are performed in thetrunk of ECA. They have own adventages and disadvantages.We 32performed STAE by PVA particulate and stainless coils in 23 cases andcompared the result with simple TAE in the malformed hemal bed in order tofind a more reasonable method of STAE. Many kinds of embolization material ,such as alcohol, thrum , glutin-sponge and TH are widely used in clinical works. Now most of doctors insistthat the malformed hemal bed should be embolized permanently by idealmaterial. PVA particulate and stainless coils were used in all cases of ourgroup and no sever complications has appeared. So, PVA particulate andstainless coils are ideal ,effective and safe embolization materials. A large number of clinical and animal experiences have improved thatthe effect of simple TAE in main branches of ECA is...