Management Approach of Vascular Anomalies of Head and Neck Region: A Clinical Study in Tertiary Care Center.

Abstract

Background: Vascular anomalies are broadly classified into vascular tumors and vascular malformations, as per the classification by the international society for the study of vascular anomalies (Kunimoto et al. Int J Mol Sci 23(1):388, 2022) (ISSVA). Vascular tumors arise due to abnormal endothelial proliferation, with infantile hemangiomas (IHs) being the most prevalent benign type, occurring in approximately 5-10% of infants (Wildgruber et al. Insights Imaging 10(1):30, 2019). These tumors demonstrate a predilection for the head and neck region and are more commonly observed in females (George et al. J Oral Maxillofac Pathol 18(Suppl 1):S117-S120, 2014). In contrast, vascular malformations represent congenital structural anomalies of blood or lymphatic vessels, resulting from errors in embryonic vascular development.

Methods: This prospective observational study was conducted over one year at a tertiary referral center, focusing on patients diagnosed with vascular Anomalies. The objective was to evaluate the clinical presentation, management strategies, and outcomes, with an emphasis on aligning treatment approaches with current literature and evidence-based protocols.

Results: A total of 45 patients were included in the study, comprising 24 males (53.33%) and 21 females (46.67%). The age of presentation ranged from infancy to 70 years. Two patients (4.44%) were infants (0-1 year), 10 patients (22.22%) were in the age group of (1-18 years), and the majority, 33 patients (73.33%), were adults (> 18 years). The most frequently involved anatomical sites were the face (46.67%) followed by the oral cavity and oropharynx (44.44%), with symptomatology varying according to lesion size, site, and extent. Surgical intervention was the most commonly employed treatment modality (44.44%), demonstrating favorable outcomes with low recurrence rates. Sclerotherapy was utilized in 35% of cases and was particularly effective for select lesion types. In the pediatric cohort, oral propranolol was administered with positive therapeutic response. Combined approaches, particularly surgery following embolization, yielded enhanced outcomes in complex or extensive lesions.

Conclusion: Surgical management remains the cornerstone of treatment for vascular malformations, offering the most definitive results and lowest recurrence rates. In selected cases, adjunctive therapies such as preoperative embolization or sclerotherapy can optimize surgical outcomes. A multidisciplinary, individualized treatment approach based on lesion type, location, and patient age is essential for optimal management of vascular anomalies.