Direct ethanol injection therapy for hemangiomas in the oral and maxillofacial region

Many treatments have been recommended for the management of hemangiomas. However, postoperative esthetics and function of the organs are often the problems for lesions in the oral and maxillofacial region. Absolute ethanol is an effective agent in the treatment of hemagiomas which may not be resectable.Two patients with hemangiomas in the oral and maxillofacial region which were treated by direct ethanol injection are described. Case 1 was an 82-year-old female with a cavernous hemangioma of the mouthfloor. Case 2 was a 64-year-old female with a venous angioma of the cheek. Both patients were admitted to our hospital because of gross swelling.However, resection of these extensive hemangiomas would most likely lead to gross disfigurement and dysfunction. We therefore tried direct ethanol injection therapy. Initially the lesions demonstrated a reactive inflammatory edema which was followed by slow resolution over several days with subsequent mild fibrosis. The lesion in case 1 required 4 ethanol injections (2ml×4) during 4 months, and the lesion in case 2 was controlled solely by a single injection (5ml). Direct ethanol injection therapy provided the greatest opportunity for preserving the surrounding normal tissue and obtaining improved cosmetic and functional results.