American society of pediatric otolaryngology vascular anomalies task force review of tongue venous malformations: Techniques, pearls, and pitfalls.

Management of tongue venous malformations can be challenging in the pediatric population due to their heterogeneity in presentation, extent of involvement and functional compromise. It is important to recognize the value of various treatment options in order to guide management of each patient in an individualized fashion. Here we describe a series of patients with tongue venous malformations that are managed using diverse modalities to illustrate the relative benefits and risks of each technique.

Reconstruction after ablative treatment of arteriovenous malformations of the head and neck.

Arteriovenous malformations are high-flow congenital vascular malformations that are characterized by abnormal connections between arteries and veins across an abnormal capillary bed. The head and neck region is the most common location for extracranial arteriovenous malformations. Due to their highly invasive, aggressive, and locally destructive nature, arteriovenous malformations are difficult to treat, and management through a multimodal, multidisciplinary approach is recommended.

Psychometric Validation of the FACE-Q Craniofacial Module for Facial Nerve Paralysis.

Systematic reviews have identified the need for a patient-reported outcome measure for facial nerve paralysis (FNP). The aim of this study was to determine the psychometric properties of FACE-Q Craniofacial module scales when used in a combined sample of children and older adults with FNP. Data were collected between December 2016 and December 2019.

Responsiveness of quality of life measures in children with peripheral vascular malformations: The OVAMA project.

Background: The OVAMA (utcome easures for scular lformations) project determined quality of life (QoL) as a core outcome domain for evaluating treatment effect in vascular malformations. To correctly evaluate treatment effect on QoL, patient-reported outcome measures (PROMs) are needed that are responsive to changes. In children with vascular malformations, we explored if two widely used PROMs were responsive to changes: the Pediatric Quality of Life Inventory (PedsQL) and the Children's Dermatology Life Quality Index (CDLQI).

Responsiveness of quality-of-life measures in patients with peripheral vascular malformations: the OVAMA project.

Background: The OVAMA (Outcome Measures for Vascular Malformations) project determined quality of life (QoL) as a core outcome domain for patients with vascular malformations. In order to measure how current therapeutic strategies alter QoL in these patients, a patient-reported outcome measurement (PROM) responsive to changes in QoL is required.

Objectives: To assess the responsiveness of two widely used generic QoL PROMs, the Medical Outcomes Study Short Form 36 (SF-36) and Skindex-29, in adult patients with vascular malformations.

Autologous Fat Grafting Restores Soft-tissue Contour Deformities after Vascular Anomaly Surgery.

Background: Soft-tissue loss is expected after resection of large vascular lesions. Autologous fat transfer improves asymmetries; however, systematic outcomes are not previously described for vascular anomaly reconstruction.

Methods: Retrospective chart review from 2012 to 2015 included patients receiving autologous fat transfers for soft-tissue defects during or following vascular anomaly surgery at a tertiary care center.

The Surgical Management of Infantile Hemangiomas.

The surgical management of facial infantile hemangiomas presents a unique challenge. The aim of the surgeon should be to remove the hemangioma and to restore normal facial features. Each of the facial zones has its own special features and challenges.

One-Stage Supramaximal Full-Thickness Wedge Resection of Vascular Lip Anomalies.

Purpose: Vascular lip anomalies include infantile hemangiomas, venous malformations, and arteriovenous malformations. Surgical management can be complicated by alterations in horizontal length, vertical height, and lip thickness from the underlying pathology. Additional reconstructive challenges include preservation of oral continence, vermillion definition, and the sublabial sulcus.

The Tissue Expander Effect in Early Surgical Management of Select Focal Infantile Hemangiomas.

Importance: The current standard of treatment for infantile hemangiomas (IHs) involves initial observation for regression throughout infancy and childhood, with or without medical management with β-blocker medications. Approximately 50% of the lesions respond almost completely to this regimen. However, the remaining 50% of the lesions, especially established focal IHs of the lip, nose, eyelids, forehead, cheek, and scalp, do not regress completely with this regimen or do so leaving a deformity; among these lesions, early surgical management may result in a superior aesthetic and functional outcome.

The Natural History of Soft Tissue Hypertrophy, Bony Hypertrophy, and Nodule Formation in Patients With Untreated Head and Neck Capillary Malformations.

Background: A percentage of patients with capillary malformation (CM) develop soft tissue hypertrophy, bony hypertrophy, and/or nodule formation.

Objective: To determine the incidence, age of onset, anatomic distribution of soft tissue/bony hypertrophy, and nodule formation in patients with untreated CM.

Methods: A retrospective medical records review of head and neck CM patients presenting to a tertiary referral center over a 7-year period (2004-2011) was performed.

Comparative Analysis of the Extracellular Matrix Composition in Proliferating and Involuted Infantile Hemangiomas.

Background: Changes in the composition of the extracellular matrix (ECM) occur between the proliferating and involuted phases of infantile hemangiomas (IH), and are associated with angiogenic growth. We examined the composition of the ECM in proliferating and involuted IHs and assessed correlations between the composition of the ECM and whether the IH was in the proliferating or the involuted phase.

Methods: We evaluated IH samples from a cohort of patients who had five proliferating IHs and five involuted IHs.

Surgical Management of Scalp Infantile Hemangiomas.

Background: Scalp infantile hemangiomas (IHs) are usually focal lesions that can be both disfiguring and may lead to complications such as ulceration and bleeding. The clinical features of scalp IHs have not been previously studied. This study aims to identify the clinical characteristics associated with scalp IH, the indications for surgical intervention, and results of surgical treatment.

Endoscopic transmucosal direct puncture sclerotherapy for management of airway vascular malformations.

Objectives/hypothesis: To describe a multidisciplinary approach to the treatment of airway vascular malformations (venous or lymphatic) with direct suspension rigid laryngoscopy and direct puncture transmucosal bleomycin sclerotherapy injected under road-mapping fluoroscopic monitoring, supplemented by Dyna-computed tomography utilization.

Study Design: Case series.

Methods: We performed a retrospective medical record and imaging review of four patients with venous malformations or lymphatic malformations located in the airway.

A Biomechanical Evaluation of Auricular Cartilage Autografts in Orbital Floor Defect Repair.

Objective: Auricular cartilage is used as a surgical implant in the management of orbital floor fractures. However, no specific parameters exist regarding the use/limitations of this potential graft. In order to determine the mechanical efficacy of adult auricular cartilage grafts, a mechanical model was developed and studied for structural threshold size limits.

Diode laser for the treatment of telangiectasias following hemangioma involution.

Objective: Infantile hemangiomas are well known for their rapid growth during the first 6 to 9 months of life, followed by a spontaneous but slow involution. The standard of care is to treat these lesions at an early age with propranolol to expedite the involution process; however, surgery still remains an active component in the management. Medical treatment with propranolol or natural involution will often result in residual telangiectasias.

Surgical treatment of head and neck port-wine stains by means of a staged zonal approach.

Background: The majority of patients with capillary malformations (port-wine stains) develop soft-tissue and bony hypertrophy leading to gross facial asymmetry and functional deficits in vision, breathing, speech, and feeding. The authors describe and illustrate a surgical approach for the treatment of these malformations with restoration of facial symmetry and contour based on facial subunits.

Methods: The authors conducted a retrospective case series of patients from 2004 to 2011 presenting for primary evaluation and treatment to a tertiary referral center specializing in vascular anomalies.

Lymphatic malformations of the airway.

Objectives/hypothesis: To characterize the anatomic distribution of lymphatic malformations of the upper airway.

Study Design: Case series with chart review.

Setting: Tertiary care referral center specializing in the diagnosis and treatment of vascular anomalies.