Large arteriovenous malformations (AVMs) of the mandible are rare and potentially life-threatening lesions. Pulsatile expansion of the buccal cortex, interdental gingival bleeding and socket haemorrhage post-extraction are typical features of high flow lesions. Due to the risk of catastrophic haemorrhage, these vascular malformations are a major challenge that require an integrated team with close cooperation between surgeons, interventional radiology and anaesthesia. Embolization and complete surgical resection of AVMs has been considered as the treatment of choice yet there remains a risk of recurrence. However, in the case of an extensive lesion, surgical removal of the nidus may be contraindicated due to the potential for a major, disfiguring deformity. Our experience in managing two extensive, life threatening AVMs of the mandible, in an 11- and a 15-year old male, will be presented and the multiple stages in their management discussed.
Management of mandibular high-flow arteriovenous malformations
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