Sclerotherapy for the treatment of bilateral mandibular intraosseous arteriovenous malformations: illustrative case.

Background: Primary intraosseous arteriovenous malformations (AVMs) are rare, especially as intraosseous lesions in the mandible. Resection, with or without embolization, has historically been the treatment of choice. There are few reports in the literature regarding the treatment of these lesions with primary sclerotherapy.

Observations: A 13-year-old female presented with significant bleeding from a progressively enlarging alveolar and gingival mass with loosening dentition following a biopsy of a left mandibular lesion. CT angiography of the head diagnosed bilateral Schöbinger stage II intramandibular AVMs. She underwent sclerotherapy using ethanol and coils for both lesions in separate sessions as the primary treatment of the lesions. Posttreatment, the patient showed no complications or recurrence, and her dentition settled into normal occlusion without mobility.

Lessons: Primary sclerotherapy using ethanol and coils can be an effective treatment option for low-stage, simple intraosseous AVMs. Further studies are needed to determine the optimal interventional treatment for intraosseous AVMs and to compare the efficacy of different sclerosants. https://thejns.org/doi/10.3171/CASE24868.