Benign oral vascular lesions treated by sclerotherapy 
with ethanolamine oleate: A retrospective study of 43 patients

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Abstract

Background

Although sclerotherapy is a common treatment for benign oral vascular lesions, there is no well-standardized protocol for this purpose. The aim of the present study was to describe the clinical characteristics of patients treated by sclerotherapy with ethanolamine oleate (EO), in order to contribute to a better understanding of this technique.

Material and Methods

Medical records and images of 90 patients treated by the same sclerotherapy protocol were retrieved and analysed. Thus, 43 cases with complete information were selected and described.

Results

The most affected age group was 41–70 years, with a female predominance and 86% of patients being Caucasian. Lips were the most affect site (70%) followed by the tongue (16%). Regarding clinical appearance, approximately 90% of lesions were classified as nodules, and 90% of patients reported no pain. Approximately 40% of lesions were 0.5–1.0 cm in size. In 58% of the patients, only one application of ethanolamine oleate was necessary. The application doses varied according to the lesion size and number of applications. Complete clinical regression occurred in 91% of cases, whereas 9% showed partial regression.

Conclusions

Sclerotherapy with EO is an acceptable, effective and affordable treatment for benign oral vascular lesions.

Key words:Hemangioma, vascular malformations, varicose veins, sclerotherapy.

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Most cited references 26

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Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics.

J Mulliken, J Glowacki (1982)

Forty-nine specimens from a variety of vascular lesions were analyzed for cellular characteristics. Two major categories of lesions emerged from this investigation: hemangiomas and vascular malformations. This classification and its implications are justified by several considerations. Hemangiomas in the proliferating phase (n = 14) were distinguished by (1) endothelial hyperplasia with incorporation of [3H]thymidine, (2) multilaminated basement membrane formation beneath the endothelium, and (3) clinical history of rapid growth during early infancy. Hemangiomas in the involuting phase (n = 12) exhibited (1) histologic fibrosis and fat deposition, (2) low to absent [3H]thymidine labeling of endothelial cells, and (3) rapid growth and subsequent regression. The endothelium in hemangiomas had many characteristics of differentiation: Weibel-Palade bodies, alkaline phosphatase, and factor VIII production. Vascular malformations (n = 23) demonstrated no tritiated thymidine incorporation and normal ultrastructural characteristics. These lesions were usually noted at birth, grew proportionately with the child, and consisted of abnormal, often combined, capillary, arterial, venous, and lymphatic vascular elements. This cell-oriented analysis provides a simple yet comprehensive classification of vascular lesions of infancy and childhood and serves as a guide for diagnosis, management, and further research.

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Vascular malformations and hemangiomas: a practical approach in a multidisciplinary clinic.

G Bisset, D. Adams, Paige L Donnelly (2000)

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Sclerotherapy of craniofacial venous malformations: complications and results.

John Mulliken, John P. Burrows, D Zurakowski … (1999)

Of all vascular anomalies, venous malformations are the most common, and they have a propensity for the head and neck. The authors retrospectively analyzed 40 patients with craniofacial venous malformations who underwent sclerotherapy between October of 1994 and June of 1996 to determine (1) the results of sclerotherapy with ethanol and/or sodium tetradecyl sulfate, (2) the types and rate of complications, and (3) whether outcome correlated with age, sex, location, size, tissues involved, morphology (lobular or varicose), venous outflow, or number of sclerotherapy sessions. The authors also reviewed the results after sclerotherapy and contour resection (n = 18). Comparisons between the results with ethanol and sodium tetradecyl sulfate and between sclerotherapy alone and sclerotherapy and resection combined were not done. The study was composed of three parts. They were (1) a review of records and imaging studies, (2) a panel evaluation of pretreatment and posttreatment photographs, and (3) a questionnaire that determined the patient's (or parent of the patient's) impression of therapy. Interrater and intrarater agreement were analyzed. Sclerotherapy was performed in an angiographic suite, under general anesthesia, using absolute ethanol and/or sodium tetradecyl sulfate. Complications of the treatment included acute blistering (50 percent), hemoglobinuria (28 percent), deep ulceration (13 percent), and nerve injury (7.5 percent). Two patients suffered transient facial paresis, and one had permanent unilateral vocal cord paralysis. Thirty patients (75 percent) were rated as having marked improvement or as being cured by all three members of the panel; 10 patients (25 percent) were rated as having no change or only slight improvement by one or more members of the panel. Interrater reliability was moderately positive, and intrarater reliability was highly positive. Thirty-seven patients or parents of patients (93 percent) responded to the questionnaire. The outcome was considered to be marked improvement or cured in 28 patients (76 percent), and nine respondents (24 percent) described only minor improvement or no change. Logistic regression analysis revealed that only male sex and number of sclerotherapeutic procedures were significant multivariate predictors of outcome. Size, location, tissues involved, morphology, or venous outflow were not determinant. In conclusion, sclerotherapy with ethanol or sodium tetradecyl sulfate is an effective and safe treatment for craniofacial venous malformations. Often, sclerotherapy has to be repeated. For extensive perioral malformations, combined sclerotherapy and resection give the best result.

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Author and article information

Journal

Journal ID (nlm-ta): Med Oral Patol Oral Cir Bucal

Journal ID (iso-abbrev): Med Oral Patol Oral Cir Bucal

Journal ID (publisher-id): Medicina Oral S.L.

Title: Medicina Oral, Patología Oral y Cirugía Bucal

Publisher: Medicina Oral S.L.

ISSN (Print): 1698-4447

ISSN (Electronic): 1698-6946

Publication date (Print): March 2018

Publication date (Electronic): 25 February 2018

Volume: 23

Issue: 2

Pages: e180-e187

Affiliations

[1 ]DDS, MsC. Oral Diagnosis Department, Piracicaba Dental School, University of Campinas – UNICAMP, Piracicaba, São Paulo, Brazil

[2 ]DDS. Oral Diagnosis Department, Piracicaba Dental School, University of Campinas – UNICAMP, Piracicaba, São Paulo, Brazil

[3 ]DDS, PhD. Oral Diagnosis Department, Piracicaba Dental School, University of Campinas – UNICAMP, Piracicaba, São Paulo, Brazil

Author notes

Faculdade de Odontologia de Piracicaba - UNICAMP Departamento de Diagnóstico Oral - Semiologia Av. Limeira, 901 CEP 13.414-903 Piracicaba - São Paulo – Brasil , E-mail: malopes@ 123456fop.unicamp.br

Conflict of interest statement: The authors state that there are no funding sources that supported the current work. The authors deny any conflicts of interest related to this study.

Article

Publisher ID: 22253

DOI: 10.4317/medoral.22253

PMC ID: 5911356

PubMed ID: 29476682

SO-VID: 820b867a-c195-464b-ab49-10049a0299d8

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Benign oral vascular lesions treated by sclerotherapy with ethanolamine oleate: A retrospective study of 43 patients

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Abstract

Background

Material and Methods

Results

Conclusions

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ScienceOpen Clinical Case Reports Collection

Most cited references 26

Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics.

Vascular malformations and hemangiomas: a practical approach in a multidisciplinary clinic.

Sclerotherapy of craniofacial venous malformations: complications and results.

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