ABSTRACT
The management of vascular anomalies has been confusing for surgeons because of an illogical and largely descriptive nomenclature that has reflected a lack of understanding of the biology of these lesions. The first step in the care of a patient with a vascular malformation is to determine whether it is a slow- or fast-flow lesion. When slow-flow malformations without direct intraosseous involvement cause secondary bony distortion, orthodontic treatment and orthognathic surgical procedures can be carried out safely without the fear of excessive bleeding. Fast-flow lesions usually produce bony destruction and extractions or orthognathic surgery is prohibitively dangerous. In combined vascular anomalies, management is based on the characteristics of the predominant, deeper malformation. Indications for treatment: Increasing size and swelling, pain, bleeding, infection, macroglossia, dysarthria, dysphagia, feeding difficulties, bone distortion and malocclusion and airway obstruction. Prolonged intubation to secure the airway and blood transfusions may be necessary.
