Curative treatment of central hemangioma in the mandible by direct puncture and embolisation with n-butyl-cyanoacrylate (NBCA)

Management of central hemangioma in the mandible is difficult because of th e abundant vascular network in this region. One of the most common signs of these patients, especially in the mixed dentition period, is hypermobility of the teeth with spontaneous hemorrhage from the surrounding gingival sul cus. Various therapeutic modalities have been considered, but surgery is th e most frequently used, In cases of a large extensive lesion, however, intr alesional injections of sclerosing agents have often been successful. A cas e of central hemangioma of the mandible with arteriovenous malformations in a 10-year-old girl is reported. She was treated with direct injection of a n embolic material, n-butyl-cyanoacrylate, which brought satisfactory resul ts. Preoperative embolisation of feeder vessels with Gelfoam and Avitene so aked in thrombin together with this direct injection is a safe treatment mo dality that is as effective as surgery. (C) 2001 Elsevier Science Ltd. All rights reserved.