Minimally invasive treatment of patients with venous malformations of the head and neck

Aim: To assess the benefits of minimally invasive methods for treating patients with venous malformations of the head and neck.

Methods: 34 medical records of patients with venous malformations of the head and neck admitted to the Vascular Department at the A.V. Vishnevsky National Medical Research Center of Surgery in the period from 2008 to 2021 were retrospectively reviewed. Patients were divided into 3 groups based on the treatment method: Group 1 (n=15) patients underwent sclerotherapy, group 2 (n=17) patients underwent laser ablation, and group 3 (n=2) – patients who underwent radiofrequency ablation. Pain syndrome was assessed using a visual analog pain scale. Health status was assessed using the SF-36 questionnaire.

Results: The mean duration of surgery varied depending on the selected method: group 1 – 27.5±19.9 mins, group 2 – 37.1±28.0 mins, group 3 – 34.8±17.0 mins. 20.6% of patients required a prolonged stay in the ICU with the mean period of 3.1±1.7 days due to upper airway edema. There were no cases of intraoperative or hospital mortality. Elastic bandaging was performed in nine (26.5%) patients. Pain syndrome was observed in all 34 patients in the early postoperative period and was not regarded as a postoperative complication. The success of the interventions was 94.1% (n=32). 73.5% of patients demonstrated complete regression of pain and swelling syndrome. Nine patients (26.4%) had partial lysis of occlusive masses within the 12-months follow-up.

Conclusion: Minimally invasive methods for treating venous malformations of the head and neck have demonstrated good clinical outcomes and low rate of postoperative complications. Further prospective randomized clinical trials are required to assess their effects and role in the treatment of this group of patients.

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