Medical Director The Yakes Vascular Malformation Center, United States
Purpose: To determine the efficacy of ethanol embolization in management of tongue venous and lymphatic malformations.
Materials and Methods: 48 patients (29 females, 19 males; mean age: 38 years) presented with tongue low-flow malformations. 47 patients had undergone 61 failed previous procedures (embo, laser, surgery, steroid injection, alpha-interpheron, radiation). All patients had baseline arteriograms and MRs. All patients underwent direct puncture ethanol endovascular therapy.
Results: Of 48 patients with venous and lymphatic malformations, 37 patients had dramatic reduction and 11 patients' therapy is on-going with concurrent reductions (mean f/up: 60 months). 1 patient with AVM required additional surgery and 1 patient with mixed veno-lymphatic malformation required surgical debulking of excess tissues. Minor complications such as tongue blisters (9 instances) healed spontaneously; 3 tongue focal areas of necrosis healed spontaneously; 3 infections responded to antibiotic treatment; 1 focal tongue hemi numbness resolved. 1 patient with dense VMs had a portion of the tongue slough and the tongue healed and remolded with no treatment required.
Conclusion: Ethanol embolotherapy is a primary and consistent form of therapy to eradicate low-flow vascular malformations of the tongue permanently at long-term follow-up. Rarely is concurrent surgery required. Ethanol sclerotherapy is a curative treatment in which recurrences do not occur and permanent ablations are the rule. Complications are minor and rare.
