Alcohol sclerotherapy to treat vascular malformations in the oral cavity

Abstract Objective To present our experience in treating vascular malformations in the oral cavity solely by injecting ethanol into the lesions. Material and methods We treated 26 patients (12 men and 14 women) with oral malformations. The diagnosis was based on clinical findings (n = 26), magnetic resonance imaging studies (n = 19), angiography findings (n = 5), and direct puncture venography (n = 2). To achieve sclerosis, we administered absolute ethanol through direct puncture. All interventions were performed under deep sedation. Results The vascular malformations treated ranged from 7 mm to 60 mm (median: 24.5 mm) in maximum diameter and had been present in the oral cavity for 0.2 to 54 years (mean: 13.6 years). The median age of the patients was 44.5 years (range: 12–87 years). The reason for treatment of the malformation was: an increase in size (n = 8), local bleeding (n = 11), risk of bleeding during dental extraction (n = 5), pain (n = 1), and esthetic purposes (n = 3). Lesions were located in the mucosa of the cheek (n = 12), in the facial gingiva (n = 5), in the labial mucosa (n = 6), in the tongue (n = 3), in the pterygomandibular region (n = 1), and in the palate (n = 1). The median dose of ethanol was 3.2 mL. Twenty lesions disappeared after a single injection session, five after two sessions, two after three sessions, and one after five sessions. In 20 cases all signs of the lesions disappeared, in 6 a bluish macule persisted, and in 2 a mass effect persisted. The symptoms improved in all patients. Only transient complications of sclerotherapy were observed: local inflammation, perioral paresthesia in two patients, and necrosis of the mucosa of the cheek in one. Conclusions Alcohol sclerotherapy is an efficacious procedure for treating vascular malformations in the oral cavity.