A 16-year retrospective study of vascular anomalies in the head and neck region

Abstract

Abstract Many different disciplines are involved in the diagnosis and treatment of vascular anomalies. Although clear communication is paramount in a multidisciplinary approach, different classification systems and nomenclatures are still used today. The ‘International Society for the Study of Vascular Anomalies’ (ISSVA) is the classification most accepted in literature and is mainly based on the radiologic and clinical presentation. We aimed to review the clinical practice of diagnosis and treatment of vascular anomalies in the head and neck region in a university hospital, with special attention for the nomenclature. All patients with a vascular anomaly who presented at the department of oral and maxillofacial surgery were reviewed in a retrospective manner. The nomenclature, diagnostic process, lesion characteristics, treatment and outcome were investigated. The lesions were classified and if necessary reinterpreted according to the ISSVA classification. A total of 185 patients were identified, of which 12.4% (n = 23) had a congenital anomaly. The most common lesions were venous malformations (n = 47, 25.4%), followed by lobular capillary hemangiomas (n = 17, 9.2%). Hundred and one patients (54,6%) received treatment, of which 93 were treated surgically (92,1% of the treated patients). Endovascular treatment was considered in 41 patients but only performed in eight. The other patients had too superficial lesions, which implies a risk of necrosis, leaving scars in the face. The histology report is a source of miscommunication, as clinicians use the ISSVA classification, while pathologists use the WHO classification. We found that both nomenclatures and classifications are used interchangeably in the clinical reports. The most used treatment modality remains surgery, notwithstanding the rise of minimally invasive techniques.