A Case of Macrocheilia Including Arteriovenous Malformation (AVM) of the Lower Lip That Was Partially Resected After Vascular Embolization in Hybrid Operating Room

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  • TERASAWA Natsumi
    Department of Plastic and Reconstructive Surgery, Aichi Medical University
  • ASAI Akiko
    Department of Plastic and Reconstructive Surgery, Aichi Medical University
  • TANAKA Mami
    Department of Plastic and Reconstructive Surgery, Aichi Medical University
  • YASUMURA Tsuneo
    Department of Plastic and Reconstructive Surgery, Aichi Medical University
  • UMEMOTO Yasutaka
    Department of Plastic and Reconstructive Surgery, Aichi Medical University
  • FURUKAWA Hiroshi
    Department of Plastic and Reconstructive Surgery, Aichi Medical University

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Other Title
  • 動静脈奇形を含んだ下口唇大唇症に対して塞栓術と部分切除術をハイブリッド手術室で同時に行った１例

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Abstract

<p>  We report the case of an 89-year-old woman who had macrocheilia including arteriovenous malformation (AVM) of the lower lip (Schöbinger stage III).<br>  She was referred to our department because of swelling and hemorrhagic ulcer of the lower lip. Pulsation and thrill were not felt on palpation of the lip.<br>  The lesion was preoperatively diagnosed as AVM by ultrasonography, CT, and MRI. We planned to perform preoperative embolization immediately before partial resection in a hybrid operating room. Based on angiographic classifications, we could choose an effective approach for embolization. After that, AVM was reduced with little hemorrhage.<br>  The post-operative course was favorable. There was no trismus or difficulty closing the mouth. The patient tolerated oral ingestion very well. There was no recurrence of symptoms about 6 months after surgery.<br>  For AVM, it is desirable to perform partial resection immediately after embolization to promote hemostatic efficacy and minimize any spread of inflammation caused by the embolizing material. Because of the patient's advanced age, it was considered important to complete the treatment in one session, so embolization and partial resection were performed simultaneously. The hybrid operating room was very useful to carry out both embolization and partial resection in a single treatment.</p>

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