EXTENSIVE FACIAL VASCULAR MALFORMATIONS AND HEMANGIOMAS - A REVIEW OFTHE LITERATURE AND CASE-REPORTS

We present 6 selected cases of extensive facial vascular anomalies ext ending to the skull base or actually involving it. These patients are compared with other cases in the literature. The spontaneous course of these vascular lesions is different and so variable treatment modalit ies are suggested depending on the age of the patient and the type of lesion. In young children, haemangiomas are common and spontaneous inv olution is characteristic. Conservative treatment in the sense of a wa it-and-see approach is thereby favoured if there is no urgent indicati on such as involvement of essential structures, e.g. blockage of an or ifice as demonstrated in one case or complications such as excessive b leeding. Vascular malformations most commonly appear in adults, there is no tendency to spontaneous involution and resection is usually nece ssary, especially in arteriovenous malformations. Nowadays, preoperati ve superselective embolization is recommended to minimize intraoperati ve blood loss. Superselective embolization is the treatment of choice in cases of a-v fistulae. Proximal ligation of the supplying arteries should be avoided because this may make embolization more difficult, a nd may be responsible for the common occurrence of rapid revasculariza tion.