Clinical study on sclerotherapy using absolute ethanol combined with polidocanol injectable foam in treatment of venous malformation in maxillofacial region of children

Objective: To evaluate the clinical efficacy of sclerotherapy using absolute ethanol combined with 3% polidocanol injectable foam in treatment of venous malformation in maxillofacial region of children. Methods: Totally 68 patients with venous malformation were treated by sclerotherapy under general anesthesia from September 2015 to July 2016. All cases were classified as two types such as fast-flow and low-flow venous malformation according to local puncture angiography. 21 cases with fast-flow venous malformations were treated by sclerotherapy using absolute ethanol and 3% polidocanol injectable foam, 47 cases with low-flow venous malformations were treated by sclerotherapy using 3% polidocanol injectable foam or with absolute ethanol. They were followed up for 6 to 15 months with an average of 10 months. The therapeutic effects and side effects were observed. The clinical evaluations were divided into four categories: cured, basic cured, effective and ineffective. Results: 47 cases of low-flow venous malformation were treated successfully, 9 cases were cured, 23 cases were basically cured, 15 cases were effective, and the total effective rate was 100%. 21 cases of fast-flow venous malformation were treated successfully, 6 cases were basically cured, 14 cases were effective, 1 case was ineffective, and effective rate was 95.2% (20/21) . The total effective rate of two types was 98.5% (67/68) . Adverse reactions: postoperative complications included transient swelling in 189 cases, blisters formed in 33 cases and lower fever in 25 cases among 211 treatments, and the symptoms were relieved obviously after symptomatic treatment. Pulmonary arterial hypertension symptoms such as rapid decline in blood oxygen and heart rate decreased after injection of absolute ethanol in 2 cases, and the symptoms disappeared after positive treatment. Skin ulceration appeared in one case, and the skin was cured after special therapy for 2 months. There was not any case with allergic reaction, ectopic embolism or nerve injury. Conclusions: Sclerotherapy using absolute ethanol combined with 3% polidocanol injectable foam is an effective and safe method with few side effect for the treatment of venous malformations in children. Key words: Venous malformation; Children; Sclerotherapy; Polidocanol; Absolute ethanol