Limits...
Extracranial vascular malformations (hemangiomas and vascular malformations) in children and adolescents - diagnosis, clinic, and therapy.

Eivazi B, Werner JA - GMS Curr Top Otorhinolaryngol Head Neck Surg (2014)

Bottom Line: The options for the treatment of venous malformations could be significantly improved during the last years.Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy.Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otolaryngology, Head & Neck Surgery, Philipps University of Marburg, Angioma Center Marburg, Germany.

ABSTRACT
The field of extracranial vascular anomalies is considered as special focus of pediatric otolaryngology and it has shown a rapid development during the last years. The reason for this interest is finally also due to the global acceptance of the classification introduced by the ISSVA (International Society for the Study of Vascular Anomalies). Hemangiomas are the most frequently observed vascular tumors. Today the systemic propranolol therapy is mostly used for therapy of hemangiomas requiring treatment. Increasingly, the topical application of beta blocker is discussed while the benefit in the head and neck seems to be limited. Vascular malformations are classified according to the morphology of the affected part of the vascular system in arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Conventional surgery, sclerosing therapy, and laser treatment are invasive options for the treatment of lymphatic malformations. The options for the treatment of venous malformations could be significantly improved during the last years. In this context, the use of Nd:YAG laser, the conservative treatment of the localized disseminated intravascular coagulation with low-molecular weight heparin, the re-discovery of bleomycin as effective sclerosing agent, and the improvement of alcohol-based embolization agents must be mentioned. Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy. Arterio-venous malformations as representatives for high-flow lesions are the high-risk lesions. Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course. The combined treatment of embolization and surgical resection and if necessary consecutive defect reconstruction have turned out to be appropriate for arterio-venous malformations. Incurable findings are still a major challenge. Despite the introduction of antiangiogenetic drugs in oncology, the medicamentous therapeutic approach could not be established for arterio-venous malformations up to now.

No MeSH data available.


Related in: MedlinePlus

Classification of the ISSVA (International Society for the Study of Vascular Anomalies) for vascular malformations (according to [3])
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4273163&req=5

T2: Classification of the ISSVA (International Society for the Study of Vascular Anomalies) for vascular malformations (according to [3])

Mentions: Vascular malformations, however, are subdivided according to the morphology of the affected area of the vascular system. The so-called Hamburg Classification that was established in 1988 divides vascular malformations into arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Those are subdivided into so-called extratruncular and truncular subtypes. Truncular forms arise from already differentiated vessels but extratruncular forms stem from the primitive embryonic vascular capillary network. The differentiation between extratruncular and truncular types takes in account the level of the occurrence of malformations with regard to the developmental stage during embryogenesis. In the head and neck area, the extra-truncular type of vascular malformations is predominantly observed. Since 1996, the further elaboration of the Hamburg Classification is the established basis for the classification of vascular malformations accepted by the ISSVA (International Society for the Study of Vascular Anomalies) (Table 2 (Tab. 2)) [3].


Extracranial vascular malformations (hemangiomas and vascular malformations) in children and adolescents - diagnosis, clinic, and therapy.

Eivazi B, Werner JA - GMS Curr Top Otorhinolaryngol Head Neck Surg (2014)

Classification of the ISSVA (International Society for the Study of Vascular Anomalies) for vascular malformations (according to [3])
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4273163&req=5

T2: Classification of the ISSVA (International Society for the Study of Vascular Anomalies) for vascular malformations (according to [3])
Mentions: Vascular malformations, however, are subdivided according to the morphology of the affected area of the vascular system. The so-called Hamburg Classification that was established in 1988 divides vascular malformations into arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Those are subdivided into so-called extratruncular and truncular subtypes. Truncular forms arise from already differentiated vessels but extratruncular forms stem from the primitive embryonic vascular capillary network. The differentiation between extratruncular and truncular types takes in account the level of the occurrence of malformations with regard to the developmental stage during embryogenesis. In the head and neck area, the extra-truncular type of vascular malformations is predominantly observed. Since 1996, the further elaboration of the Hamburg Classification is the established basis for the classification of vascular malformations accepted by the ISSVA (International Society for the Study of Vascular Anomalies) (Table 2 (Tab. 2)) [3].

Bottom Line: The options for the treatment of venous malformations could be significantly improved during the last years.Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy.Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otolaryngology, Head & Neck Surgery, Philipps University of Marburg, Angioma Center Marburg, Germany.

ABSTRACT
The field of extracranial vascular anomalies is considered as special focus of pediatric otolaryngology and it has shown a rapid development during the last years. The reason for this interest is finally also due to the global acceptance of the classification introduced by the ISSVA (International Society for the Study of Vascular Anomalies). Hemangiomas are the most frequently observed vascular tumors. Today the systemic propranolol therapy is mostly used for therapy of hemangiomas requiring treatment. Increasingly, the topical application of beta blocker is discussed while the benefit in the head and neck seems to be limited. Vascular malformations are classified according to the morphology of the affected part of the vascular system in arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Conventional surgery, sclerosing therapy, and laser treatment are invasive options for the treatment of lymphatic malformations. The options for the treatment of venous malformations could be significantly improved during the last years. In this context, the use of Nd:YAG laser, the conservative treatment of the localized disseminated intravascular coagulation with low-molecular weight heparin, the re-discovery of bleomycin as effective sclerosing agent, and the improvement of alcohol-based embolization agents must be mentioned. Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy. Arterio-venous malformations as representatives for high-flow lesions are the high-risk lesions. Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course. The combined treatment of embolization and surgical resection and if necessary consecutive defect reconstruction have turned out to be appropriate for arterio-venous malformations. Incurable findings are still a major challenge. Despite the introduction of antiangiogenetic drugs in oncology, the medicamentous therapeutic approach could not be established for arterio-venous malformations up to now.

No MeSH data available.


Related in: MedlinePlus