Challenges in the management of massive intraorbital and hemifacial arteriovenous malformation as causing life-threatening epistaxis

Anura Michelle Manuel; Santhi Kalimuthu; Sitra Siri Pathmanathan; Prepageran Narayanan; Zurina Zainal Abidin; Khairul Azmi; Alizan Khalil

doi:10.1016/j.asjsur.2013.09.011

Challenges in the management of massive intraorbital and hemifacial arteriovenous malformation as causing life-threatening epistaxis

Asian J Surg. 2017 Apr;40(2):158-162. doi: 10.1016/j.asjsur.2013.09.011. Epub 2013 Nov 6.

Authors

Anura Michelle Manuel¹, Santhi Kalimuthu², Sitra Siri Pathmanathan², Prepageran Narayanan², Zurina Zainal Abidin³, Khairul Azmi⁴, Alizan Khalil⁵

Affiliations

¹ Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: anuramichelle@yahoo.com.
² Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
³ Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁴ Department of Radiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁵ Department of Plastic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

PMID: 24210537
DOI: 10.1016/j.asjsur.2013.09.011

Abstract

Arteriovenous malformations are congenital lesions that may evolve with time and manifest in a plethora of presentations. They can occur as torrential epistaxis when it extensively involves the facial region. Multi-imaging modalities are available to assist in characterizing the structure of the lesion as well as its location and extent. This complex disease requires a multidisciplinary team approach with preoperative embolization and surgery. We present a rare cause of life-threatening epistaxis in a gentleman with a longstanding orbital and hemifacial arteriovenous malformation and discuss the complexities involved in its management.

Keywords: arteriovenous malformation; epistaxis; hemifacial.

Publication types

Case Reports

MeSH terms

Adult
Arteriovenous Malformations / complications
Arteriovenous Malformations / diagnostic imaging
Arteriovenous Malformations / therapy*
Carotid Artery, Common / abnormalities*
Carotid Artery, Common / diagnostic imaging
Carotid Artery, Internal / abnormalities
Carotid Artery, Internal / diagnostic imaging
Cerebral Angiography / methods*
Combined Modality Therapy
Edema / diagnosis
Edema / etiology
Embolization, Therapeutic / methods
Epistaxis / diagnosis*
Epistaxis / etiology
Exophthalmos / diagnosis
Exophthalmos / etiology
Eyelid Diseases / diagnosis
Eyelid Diseases / etiology
Follow-Up Studies
Humans
Magnetic Resonance Angiography / methods
Male
Orbit / blood supply
Orbit Evisceration / methods
Plastic Surgery Procedures / methods*
Risk Assessment
Severity of Illness Index
Surgical Flaps / blood supply
Surgical Flaps / transplantation
Treatment Outcome