INSTILLATION OF ALCOHOL INTO VENOUS MALFORMATIONS OF THE HEAD AND NECK

Vascular malformations are errors of vascular morphogenesis, and must be differentiated from vascular tumours such as haemangiomas, because the natural history and treatment are different. Vascular malformation s may be arteriovenous with high blood flow, or venous with low blood flow. Venous vascular malformations grow among soft tissues and are di fficult to delineate at operation. Direct puncture under fluoroscopy w ith injection of contrast medium is one method of visualising the cavi ties of a venous malformation. Instillation of concentrated alcohol di rectly into such cavities is a possible treatment. Forty-four patients with venous malformations of the head or neck have been treated since 1984, of whom 31 responded to a follow up questionnaire. Twenty-three responded to injection of ethanol alone, and eight also required reco nstructive surgery; 26 of the 31 described the result as ''good'' or ' 'excellent'' (84%).