Ethanolamine oleate as a secleroting agent in the treatment of low flow facial and oral vascular lesions

Background :Vascular lesions of the head and neck are wide range of different pathologies including haemangiomas and vascular malformations. The diagnosis is usually clinical . The vascular elements and blood flow are better diagnosed by angiography . Vascular lesions require treatment when they are symptomatic or causing patient discomfort. A number of therapeutic ways and procedures were proposed for the management of vascular lesions including systemic and intralesional steroids , intralesional sclerosing agents , interferon , laser therapy, embolization , cryotherapy as well as radiation. Ethanolamine oleate is an organic chemical compound as a primary amine and a primary alcohol can cause a dose related inflammatory reaction when introduced inside the tissues leading to fibrosis and reduction of the size affecting lesions. Aim:To evaluate the efficacy of ethanolamine oleate 5% in the treatment of oral and facial vascular malformations. Patients and methods: This is a prospective cross-sectional study included 24 patients with vascular lesions ranging between 1 and 65 years of age in Al-Sader Medical City , Najaf , Iraq during the period from 2012 to 2015 . Ethanolamine oleate 5% solution was used to treat these lesions . The age and gender of patients, site and size of the lesion , the dose of the agent used , the immediate tissue reactions , the general constitutional symptoms and the outcome were all studied. Results: Among 200 patients visited the maxillofacial department in the Al-Sader Medical City, 24 patients appear to have an oral or facial vascular lesion. All the 24 patients were included in this study. The amount of the agent used in the treatment was calculated , 0.3 -2.5 mL according to the size of the lesion. Sever pain , swelling and ulceration were constant in all treated patients. Lesions of one cm to 2.5 cm size showed good response after the first session , but larger lesions required a second or even a third session. Discussion: Vascular lesions of the oral cavity and face are treated in many different ways .High flow lesions require presurgical embolozation followed by aggressive ablative therapy. Slow flow vascular malformations can be managed in numerous ways including sclerotherapy. The size and site of the lesion determines the dose and the number of injections of athanolamine oleate as a sclerosing agent. Sever pain , immediate swelling and airway embarrassment when the lesion is oral , ulceration and corresponding bleeding are important clinical aspects but if they are weighted against the dramatic reduction in size and appearance , the results are fruitful both for the patient and the doctor.