Oral and Maxillofacial Surgery Cases (Jun 2022)
Bleomycin intralesional injections of maxillofacial venous malformations in pediatric patients
Abstract
Background: Most venous malformations (VMs) present in the head and neck region. Many sclerosing agents have been documented in the literature, but Bleomycin is a new promising sclerosing agent of facial venous malformations. Objectives: this study was conducted to evaluate the clinical outcome and safety of Bleomycin (BL) intralesional injections in management of maxillofacial venous malformation in pediatric patients. Methods: 15 patients of both sexes and of age up to 12 years having VMs in the maxillofacial region were randomly selected from the vascular anomalies clinic in Cairo University Specialized Pediatric Hospital. All patients were treated by BLM intralesional injections with the safe pediatric dose of 0.5 IU/kg, at 4 weeks intervals with maximum dose of 15 IU/session. All cases were performed by the same operator, and patients were followed up over 12 months after last injection. Results: Twelve patients had complete response (>90% improvement), and 3 patients had marked improvement response. Eleven patients were injected under topical local anaesthesia, and 4 patients had regional local anaesthesia. All patients had post-operative swelling that lasted for 3–5 days. There was no pain during or after injections, no ulceration, no weight loss, no hair loss and no signs of pulmonary fibrosis throughout the follow up time. Recurrence occurred only in 2 patients due to noncompliance with sessions, and they were re-injected with BLM. Conclusion: this study has shown that Bleomycin is safe, effective and an excellent therapy for treating VMs in the maxillofacial region. No systemic or local complications had occurred.
