TREATMENT OF ARTERIOVENOUS MALFORMATION OF THE FACE ASSOCIATING RESECTION AND MODIFIED AUERSVALD HEMOSTATIC NET

• DOI: https://doi.org/10.22533/at.ed.15941624050110

• Palavras-chave: Surgical treatment; arteriovenous malformation; Face.

• Keywords: Surgical treatment; arteriovenous malformation; Face.

• Abstract:

  INTRODUCTION: The treatment of arteriovenous malformations (AVM) in the face is complex due to the high rate of recurrence and complications related to functional and aesthetic impairment. This article describes the treatment of an AVM in the supra-orbital and frontal region, combining resection and modified Auersvald hemostatic mesh in a 23-year-old patient. CASE REPORT: ACSP patient, female, 23 years old, with a pulsatile reddish mass involving the supra orbital, left frontal region of progressive growth, whose initial presentation was a congenital red spot in the same topography. After embolization was contraindicated due to the risk of brain damage such as amaurosis, we opted for surgical treatment combining partial resection of the lesion through coronal access with skin preservation followed by the use of a modified Auersvald hemostatic network. RESULT: The patient maintained the use of the hemostatic network for 2 months after surgical resection. A progressive decrease in the volume of the lesion was observed. The skin involved in the lesion remained well perfused, progressing with a progressive improvement in its appearance. There was no damage to the frontal branch of the facial nerve. DISCUSSION: AVMs have the ability to infiltrate noble structures, causing serious functional consequences. The objectives of surgery are based on the maximum possible resection of the tumor mass, maintaining the function of the affected area and avoiding complications, such as injury to adjacent nerves, bleeding and ischemia. Repetition and reinterventions are frequent, making these conditions a challenge for our specialty. CONCLUSION: The treatment of AVMs on the face combining resection and the use of a modified Auersvald hemostatic mesh presents itself as an option in the treatment of lesions that do not respond to embolization or that present a prohibitive risk.