Effect of Foam and Liquid Bleomycin in the Management of Venous Malformations in Head and Neck Region. A Comparative Study

Document Type : Original Article

Author

The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Background: Many treatment options for Venous Malformations
(VM) has been documented in the literature but injection
sclerotherapy has been considered a current mainstay for their
treatment. We conducted this study to determine efficacy and
durability of different injectable forms of bleomycin sclerotherapy
in the treatment of VMs in cervico-facial region.
Patients and Methods: Thirty patients complaining of
venous malformation in the head and neck region, diagnosed
clinically and confirmed by magnetic resonance imaging, had
been injected with bleomycin sclerosing material. They were
divided into two equal groups according to the form of
bleomycin injected; Group A: Foam form was injected and
Group B: Liquid form was injected. Patient's data, anatomical
sites, type and volume of the VM, number of injection sessions
and the average dose of injected agents were documented and
statistically compared between the 2 groups.
Results: MRI imaging showed a decline of more than
90% from the initial size of lesions in 66.7% cases and
considerable decline (60%-90%) in 33.3% of cases. In Group
A the number of sessions were (1-4), while in Group B were
(1-6). the amount of sclerosing material injected in Group A
were (2-7.5mg), while in Group B were (3.5-13mg), which
was statistically significant. The cumulative dose in the equal
size lesions was lower in the foam form rather than the liquid
one, and show statistically significant difference.
Conclusion: Foam form has greater promise compared
with liquid form in the treatment of VMs and would encourage
us to continue use the bleomycin in its foam form in the future
on a bigger number of patients with larger size lesion and
different location without reaching to the toxic cumulative
life time dose.

Keywords

Main Subjects

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The Egyptian Journal of Plastic and Reconstructive Surgery
Volume 43, Issue 3
October 2020
Pages 401-408

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