Management of Tongue Venous and Lymphatic Malformations

Wednesday, March 8, 2023

4:03 PM – 4:12 PM

Location: Phoenix Convention Center, 225AB

Presenting Author(s)

Wayne Yakes, MD

Medical Director
The Yakes Vascular Malformation Center

Disclosure(s): No financial relationships to disclose

Disclosure(s):

Wayne Yakes, MD: No financial relationships to disclose

Purpose: To determine the efficacy of ethanol embolization in management of tongue venous and lymphatic malformations.

Materials and Methods: 48 patients (29 females, 19 males; mean age: 38 years) presented with tongue low-flow malformations. 47 patients had undergone 61 failed previous procedures (embo, laser, surgery, steroid injection, alpha-interpheron, radiation). All patients had baseline arteriograms and MRs. All patients underwent direct puncture ethanol endovascular therapy.

Results: Of 48 patients with venous and lymphatic malformations, 37 patients had dramatic reduction and 11 patients' therapy is on-going with concurrent reductions (mean f/up: 60 months). 1 patient with AVM required additional surgery and 1 patient with mixed veno-lymphatic malformation required surgical debulking of excess tissues. Minor complications such as tongue blisters (9 instances) healed spontaneously; 3 tongue focal areas of necrosis healed spontaneously; 3 infections responded to antibiotic treatment; 1 focal tongue hemi numbness resolved. 1 patient with dense VMs had a portion of the tongue slough and the tongue healed and remolded with no treatment required.

Conclusion: Ethanol embolotherapy is a primary and consistent form of therapy to eradicate low-flow vascular malformations of the tongue permanently at long-term follow-up. Rarely is concurrent surgery required. Ethanol sclerotherapy is a curative treatment in which recurrences do not occur and permanent ablations are the rule. Complications are minor and rare.