Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Outcomes of Surgical Treatment of Vascular Anomalies on the Vermilion

  • Park, Sang Min (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Bae, Yong Chan (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Lee, Jae Woo (Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine) ;
  • Kim, Hoon Soo (Department of Dermatology, Pusan National University School of Medicine) ;
  • Lee, In Sook (Department of Radiology, Pusan National University School of Medicine)
  • Received : 2015.04.15
  • Accepted : 2015.09.01
  • Published : 2016.01.15
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Abstract

Background The vermilion plays an important role in both the aesthetic and functional aspects of facial anatomy. Due to its structural features, the complete excision of vascular anomalies on the vermilion is challenging, making it difficult to determine the appropriate treatment strategy. Thus, the authors analyzed the results of surgical treatment of vascular anomalies on the vermilion. Methods The medical records of 38 patients with vascular anomalies on the vermilion who underwent surgery from 1995 to 2013 were analyzed. Nine of the cases had an involuted hemangioma, and 29 cases had a vascular malformation; of the vascular malformations, 13, 11, one, and four cases involved were capillary malformations (CMs), venous malformations (VMs), lymphatic malformations (LMs), and arteriovenous malformations (AVMs), respectively. We investigated the surgical methods used to treat these patients, the quantity of surgical procedures, complications and instances of recurrence, and self-assessed satisfaction scores. Results A total of 50 operations were carried out: 28 horizontal partial excisions, eight vertical partial excisions, and 14 operations using other surgical methods. All cases of AVM underwent complete excision. Six cases experienced minor complications and one case of recurrence was observed. The overall average satisfaction score was 4.1 out of 5, while the satisfaction scores associated with each lesion type were 4.2 for hemangiomas, 3.9 for CMs, 4.2 for VMs, 5.0 for LMs, and 4.0 for AVMs. Conclusions It is difficult to completely excise vascular anomalies that involve the vermilion. This study suggests that partial excision focused on correcting the overall contour of the lips is effective and leads to satisfactory results.

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References

  1. Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982;69:412-22. https://doi.org/10.1097/00006534-198203000-00002
  2. Jackson IT, Carreno R, Potparic Z, et al. Hemangiomas, vascular malformations, and lymphovenous malformations: classification and methods of treatment. Plast Reconstr Surg 1993;91:1216-30. https://doi.org/10.1097/00006534-199306000-00006
  3. Enjolras O, Mulliken JB. Vascular tumors and vascular malformations (new issues). Adv Dermatol 1997;13:375-423.
  4. Chim H, Drolet B, Duffy K, et al. Vascular anomalies and lymphedema. Plast Reconstr Surg 2010;126:55e-69e. https://doi.org/10.1097/PRS.0b013e3181df803d
  5. Neligan P. Plastic surgery. New York: Elsevier Saunders; 2013.
  6. Arneja JS, Gosain AK. Vascular malformations. Plast Reconstr Surg 2008;121:195e-206e. https://doi.org/10.1097/01.prs.0000304607.29622.3c
  7. Greene AK. Management of hemangiomas and other vascular tumors. Clin Plast Surg 2011;38:45-63. https://doi.org/10.1016/j.cps.2010.08.001
  8. Spring MA, Bentz ML. Cutaneous vascular lesions. Clin Plast Surg 2005;32:171-86. https://doi.org/10.1016/j.cps.2004.11.004
  9. Elluru RG. Cutaneous vascular lesions. Facial Plast Surg Clin North Am 2013;21:111-26. https://doi.org/10.1016/j.fsc.2012.11.001
  10. Stier MF, Glick SA, Hirsch RJ. Laser treatment of pediatric vascular lesions: Port wine stains and hemangiomas. J Am Acad Dermatol 2008;58:261-85. https://doi.org/10.1016/j.jaad.2007.10.492
  11. Hennedige AA, Quaba AA, Al-Nakib K. Sturge-Weber syndrome and dermatomal facial port-wine stains: incidence, association with glaucoma, and pulsed tunable dye laser treatment effectiveness. Plast Reconstr Surg 2008;121:1173-80. https://doi.org/10.1097/01.prs.0000304606.33897.71
  12. Kim Y, Oh SJ, Lee J, et al. Surgical treatment of dermatomal capillary malformations in the adult face. Arch Plast Surg 2012;39:126-9. https://doi.org/10.5999/aps.2012.39.2.126
  13. Sun ZJ, Zhang L, Zhang WF, et al. Epithelioid hemangioma in the oral mucosa: a clinicopathological study of seven cases and review of the literature. Oral Oncol 2006;42:441-7. https://doi.org/10.1016/j.oraloncology.2005.07.012
  14. Visser A, FitzJohn T, Tan ST. Surgical management of arteriovenous malformation. J Plast Reconstr Aesthet Surg 2011; 64:283-91. https://doi.org/10.1016/j.bjps.2010.05.033
  15. Barrett AW, Speight PM. Superficial arteriovenous hemangioma of the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:731-8. https://doi.org/10.1067/moe.2000.108806
  16. Smith MC, Zimmerman MB, Burke DK, et al. Efficacy and safety of OK-432 immunotherapy of lymphatic malformations. Laryngoscope 2009;119:107-15. https://doi.org/10.1002/lary.20041
  17. Kulungowski AM, Fishman SJ. Management of combined vascular malformations. Clin Plast Surg 2011;38:107-20. https://doi.org/10.1016/j.cps.2010.08.009
  18. Steiner F, FitzJohn T, Tan ST. Surgical treatment for venous malformation. J Plast Reconstr Aesthet Surg 2013;66:1741-9. https://doi.org/10.1016/j.bjps.2013.07.033
  19. Lin XX, Wang W, Wu SF, et al. Treatment of capillary vascular malformation (port-wine stains) with photochemotherapy. Plast Reconstr Surg 1997;99:1826-30. https://doi.org/10.1097/00006534-199706000-00004