Management of high-flow arteriovenous malformation in the maxillofacial region.

Management of high-flow arteriovenous malformation (AVM) in the oral and maxillofacial region, one of the greatest challenges facing oral and maxillofacial surgeons, is patient-specific in almost all cases. The aim of this study was to review our experience with superselective intra-arterial embolization followed by surgical resection and bone wax packing (BWP) of the bone cavity and curettage to manage AVM. Sixteen patients with AVM of the oral and maxillofacial region were included in this study. All patients were evaluated with preoperative angiography, and superselective intra-arterial embolization of the lesions was done in the same session by the same interventional radiologists. Forty-eight to 72 hours later, surgical resection of the soft-tissue vascular lesions and BWP of the bone cavity and curettage were performed. There were no complications related to either the preoperative angiography or the embolization procedure. The pulsation and noise were absent, and the hemorrhage disappeared. Followed up after the surgical treatment for a mean of 38 months (range, 7-63 months), 14 cases were controlled and 2 were improved, and no case was persistent or recurred. Superselective intra-arterial embolization followed by surgical resection and BWP of the bone cavity and curettage was an effective therapy in the oral and maxillofacial region.