Cervicofacial vascular anomalies. II. Vascular malformations
Section snippets
Diagnostic modalities
To ensure proper outcomes, accurate and expeditious diagnosis is essential. To a large extent, the diagnosis is determined after a thorough and complete history and physical examination. Key parts of the patient’s history include: (1) the age at which parents initially noticed the lesion, (2) the overall rate of growth of the lesion as well as recent changes in the size of the lesion, and (3) acute changes in the size of the lesion concordant with upper respiratory tract infections, trauma,
Capillary malformations
Capillary malformations are the most commonly occurring subgroup of vascular malformations. This malformation consists of a superficial collection of ecstatic vessels that are located in the papillary and superficial reticular dermis, with a mean depth of 0.46 mm.7 In infancy, these lesions are extremely common and manifest as macular capillary stains, colloquially referred to as “angel’s kiss” or “stork’s bite.” They generally appear as pink macules on the forehead, eyelids, nose, and nuchal
Venous malformations
Congenital venous malformations consist of either localized or diffuse ecstatic veins with abnormal collections of irregular venous channels having flat, mitotically inactive endothelia and scant mural smooth muscle. These lesions may be superficial (ie, intradermal or subcutaneous) (Figure 2) or deep (ie, intramuscular or intraosseous). For the most part, they are asymptomatic. Superficial venous malformations have a bluish compressible mass with no palpable thrill or audible bruit. These
Lymphatic malformations
Lymphatic malformations are benign vascular lesions and appear to arise from embryological disturbances in the development of the lymphatic system. They encompass a wide spectrum of abnormalities, including cystic lymphatic lesions (formerly referred to as “lymphangiomas”), lymphangiectasis, and lymphedema.1 Given that lymphangiectasis and lymphedema usually involve sites other than the head and neck, these topics will not be further discussed in this article.
Cystic lymphatic malformations can
Arteriovenous malformations
Arteriovenous malformations (AVMs) are congenital vascular lesions associated with a variable degree of arteriovenous shunting.1, 5 These lesions most commonly occur in the head and neck, but involvement in other body regions is also seen (Figure 5). Some AVMs are thought to originate from arteriovenous channels that have failed to regress during development. These high-flow communications between arteries and veins are among the most dangerous vascular anomalies. They are always multiple and
Telangiectatic vascular malformations
Hereditary Hemorrhagic Telangiectasia (HHT) or Rendu-Osler-Weber Syndrome is an autosomal dominant vascular anomaly characterized by multiple mucocutaneous and visceral vascular lesions.1, 33 These lesions begin in the capillary beds as tiny capillary-venous shunts, usually after puberty. The characteristic lesions of HHT are discrete, spider-like, bright- red maculopapules, usually 1 to 4 mm in diameter. They are typically located on the face, tongue, lips, conjunctiva, palmar aspect of the
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2023, Brazilian Journal of OtorhinolaryngologyPartial resection of a face and neck lymphatic malformation after tracheostomy: A case of difficult airway management
2022, Journal of Pediatric Surgery Case ReportsCitation Excerpt :It is often detected by fetal ultrasonography, and 90% is diagnosed by the age of 2 years [4]. It can occur in lymphatic vessels throughout the body, but the head and neck are the most common, accounting for more than 50% of cases [1,5]. When the lesion is located in the head and neck region, it causes symptoms such as airway obstruction, bleeding, infection, difficulty in oral intake, and dysmorphic features [6].
The genetics of vascular birthmarks
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