04 April 2022: Articles
Management of an Extensive Intraparotid and Auricular Arteriovenous Malformation
Rare disease
Sze Ying Yee E* , Shuyi Guo E , Chi Long Ho EDOI: 10.12659/AJCR.935337
Am J Case Rep 2022; 23:e935337
Table 3. Summary of the reported cases of arteriovenous malformation of the parotid gland in the literature.
| Authors | Nr pt | Age (y), gender | Lesion site | Presenting symptoms, duration (Schobinger clinical stage) | Key diagnostic studies and findings | Main feeding arteries | Treatment | Follow up (FU) duration; outcome |
|---|---|---|---|---|---|---|---|---|
| Hamden AL (2001) []22 | 1 | 20 y, F | L parotid | Enlarging left cheek mass with palpable thrills 1 y (Stage II) | MRI and Angio: AVM involving the superficial and deep lobes of the parotid | MA, LA, FA | Embo >> Exc | NA |
| Chen WL (2009) []23 | 13 (range 5–13); | 9.1 y 10 M, 3 F | Parotid, cheek, mandible, maxilla, floor of mouth | Facial asymmetry, skin discoloration, pulsation, wind- blowing noise, gingival bleeding, intraoral hemorrhage after tooth extraction (Stage III) | CTA | IAA, LA, MA, FA, STA | Embo only, Embo >> Scleroth. Exc | 13.5 m (range 6–22 m). 69.2% of AVMs involuted, 23.1% mostly involuted + partial involution in 7.7%. Reduction of AVM size and cure rates after Exc were 23.1% and 84.6%, respectively |
| Shailaja SR (2012) []24 | 1 | 18 y, F | R parotid | R hemifacial swelling 1y and pain R lower back 6 m, with bruit (Stage III) | MRI+MRA: multiple flow voids in R parotid, ramus and condyle of the mandible | FA | NA | NA |
| Anesti K (2014) []5 | 1 | 34 y, M | L parotid and auricle | Progressive enlargement, bleeding, pain, skin tightness and pulsations at night (Stage III) | MRI: vascular malformation of L ECA supplying scalp and L ear | STA, OA | Embo >> Exc+MCF closure | No recurrence |
| Bhatia C (2017) []25 | 1 | 55 y, F | R parotid | Swelling in front and below R ear 1 y (Stage II) | MRI: R parotid enlargement with multiple tubular enhancing structures traversing the R parotid | NA | Exc | NA |
| John H (2020) []26 | 1 | 47 y, F | L parotid | Pain and swelling in front of L ear, 4 m (Stage III) | MRI+MRA: AVM in the superficial parotid lobe | FA | Scleroth (prior Ex ?) | No recurrence |
| Gupta M (2021) []27 | 2 | pt 1: 32 y, F; pt 2: 43 y, M | pt 1: R parotid pt 2: L parotid | pt 1: Swelling below R ear, 8 y (Stage III); pt 2: Swelling below and front of L ear, 1.5 y (Stage II) | pt 1: CECT: Enhancing parotid with multiple pin head calcifications. pt 2: MRI: T2w hyperintensity with few lobulated hypointense foci within parotid | NA | Pt 1: Exc Pt 2: Exc | Pt 1: 1 m; no recurrence Pt 2: NA |
| Yee & Ho (2022) [current study] | 1 | 40 y, F | L parotid and L auricle | Swelling with palpable thrills, 6 m (Stage II) | MRI: Serpiginous vessels with “honeycomb” flow voids | PAA, STA | Embo. >> Exc+MCF closure | 3.5 y, no recurrence |
| Angio – angiography; AVM – arteriovenous malformation; BWPC – bone wax packing and curettage; CTA – computed tomography angiography; CECT – contrast enhanced CT; Embo – embolization; DS – Doppler sonography; ECA – external carotid artery; Exc – excision; FA – facial artery; LA – lingual artery; IAA – inferior alveolar artery; ICA – internal carotid artery; MA – maxillary artery; MCF – musculocutaneous flap; MRI – magnetic resonance imaging; MRA – magnetic resonance angiography; NA – no available information; nr – number(s); OA – occipital artery; PAA – posterior auricular artery; PAL – proximal artery ligation; PT – pulsatile tinnitus; Scleroth – sclerotherapy; STA – superficial temporal artery; STSG – Split-Thickness Skin Graft; Symbols >> – followed by;+ – and; F – female; M – male; m – month(s); pt – patient; R – right; L – left; y – year(s). | ||||||||