Malagón-Hidalgo HO, Ayala-Ugalde FA, García-Cano E, Molina-Ortega JE

Language: Spanish
References: 0
Page: 22-27
PDF size: 350.81 Kb.

ABSTRACT

Arteriovenous malformations are the most common high-flow lesions. The size of the lesion increases proportionally during growth, which can cause asymmetries, pain, functional, aesthetic, psychological alterations, even putting life in danger because of the risk of bleeding without adequate diagnosis and treatment. A multidisciplinary approach is recommended for treatment. A 37-year-old male patient with vascular tumor of 11 years of evolution underwent preoperative embolization with guided onyx with supra-selective catheterization by the maxillary and left facial artery. One day after embolization, resection we performed a marking, resection of the lesion and planning of reconstruction with local flaps. The evolution of arteriovenous malformations in the facial region is unpredictable and the psychological alterations they cause in patients are devastating. For its complete control and healing, it is necessary to remove the symptomatic area, replacing it with vascularized tissue that obliterates the ischemic environments caused by this malformation. Reconstruction planning should be done with respect to aesthetic units and subunits, although this involves the combination of two surgical techniques or two types of flaps, as in the present case, to obtain satisfactory aesthetic and functional results. Flap advancement and rotation can be an excellent alternative to the microsurgical flap, providing additional cosmetic benefits by repairing the contour of the deformity with less risk of complications and lower morbidity of the donor area, and does not require special training in microsurgery.