Medical Director The Yakes Vascular Malformation Center, United States
Purpose: To determine the efficacy of Ethanol Endovascular Repair of Ear Arteriovenous Malformations (AVMs).
Materials and Methods: 14 patients (9 female, 5 males; age range 6-39 years; mean age: 22 years) with ear AVMs presented for therapy. 2 patients had failed prior embolizations (PVA/coils/nBCA/steroids) and 2 patients had other therapies (laser/excisions/grafting). All patients presented with a grossly enlarged painful ear, and 5 patients had intermittent bleeding. All patients underwent transcatheter and direct puncture ethanol treatments. (86 procedures).
Results: All 14 patients were cured of their AVM at long-term follow-up (mean follow-up: 52 months). 1 patient had transient partial VII nerve palsy. 2 patients had minor blisters and ear injuries that healed on the outer tragus. The longest arteriographic follow-up demonstrating cure is 12 years, and clinical cure is 32 years.
Conclusion: Ethanol endovascular repair of ear AVMs can achieve cures in this vexing lesion that previously was treated with resection of the ear with complex plastic surgical reconstructions and with recurrence rates. This series documents long-term cures of AVMs of the ear and scalp that were not treatable by endovascular approaches as previously documented in the world’s literature. Permanent treatment of the auricular AVMs is documented and no recurrence occurred in any patient. Only one article is published (group from Shanghai, China) emulating this technique also with curative results.
