Intraosseous focal venous malformation of the mandibular body: cone beam computed tomography planning followed by piezoelectric knife resection and free bone graft reconstruction

Živorad S. Nikolić; Drago B. Jelovac; Melvil Šabani; Jelena V. Jeremić; Ivan Boričić

doi:10.2298/VSP150616225N

Živorad S. Nikolić Faculty of Dentistry, University of Business Academy, Pančevo, Serbia
Drago B. Jelovac Clinic for Maxillofacial Surgery, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia.
Melvil Šabani Clinic for Maxillofacial Surgery, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia.
Jelena V. Jeremić Clinic for Burns, Plastic and Reconstructive Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Ivan Boričić Institute for Pathology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP150616225N

Keywords: mandibular neoplasms, hemangioma, diagnosis, cone-beam computed tomography, oral surgical procedures, bone transplantation,

Abstract

Introduction. Intraosseous vascular malformation could be life-threatening due to uncontrolled hemorrhage after tooth extraction. According to biological behavior of this lesion, adequate diagnostic and treatment strategies are necessary in order to avoid possible complications. We reported cone beam computed tomography (CBCT) planning of an urgent en bloc resection of an intraosseous venous malformation by piezoelectric knife. Case report. A 55-year-old man was submitted to CBCT planning followed by piezoelectric knife resection of an intraosseous focal venous malformation of the mandibular body. Immediate reconstruction of the defect using iliac bone free graft was performed. The surgical treatment was uneventful and a 2-year follow-up revealed no signs of recurrence.
Conclusion. Piezoelectric knife could provide precise, safe and bloodless procedure which is especially important in this pathology. Advantages of this technique are: lower risk of damaging soft tissue structures, precise osteotomy and bloodless surgery. Moreover, using piezosurgery bone knife, blood transfusion and blood transmitted diseases could be avoided. This case highlights the importance of CBCT as planning tool for resection of the mandible, using piezoelectric knife as safe method to achieve bloodless surgery.

Author Biographies

Živorad S. Nikolić, Faculty of Dentistry, University of Business Academy, Pančevo, Serbia

No

Drago B. Jelovac, Clinic for Maxillofacial Surgery, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia.

No

Melvil Šabani, Clinic for Maxillofacial Surgery, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia.

No

Jelena V. Jeremić, Clinic for Burns, Plastic and Reconstructive Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

No

Ivan Boričić, Institute for Pathology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

No

References

Enjolras O, Wassef M, Chapot RO. Color Atlas of Vascular Tu-mors and Vascular Malformations, 1st ed. West Nyack (NY): Cambridge University Press; 2009.

Mulliken JB, Glowacki J. Hemangiomas and vascular malforma-tions in infants and children: A classification based on endo-thelial characteristics. Plast Reconstr Surg 1982; 69(3): 412−22.

Adler CP, Wold L. Heamangioma and related lesions. In: Fletch-er CD, Unni KK, Mertens F, editors. Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC Press; 2002. p. 320−1.

Bruder E, Perez-Atayde AR, Jundt G, Alomari AI, Rischewski J, Fishman SJ, et al. Vascular lesions of bone in children, adoles-cents, and young adults. A clinicopathologic reappraisal and application of the ISSVA classification. Virchows Arch 2009; 454(2): 161−79.

Stošić S, Anđelić G, Tomić LJ. Contemporary concept in classifi-cation of vascular anomalies of head and neck. MD-Medical Data 2011; 3(4): 383−6.

Stošić S. Vascular anomalies of head and neck. Belgrade: Od-brana; 2012. (Serbian)

Cheng N, Lai D, Hsie M, Liao S, Chen YT. Intraosseous heman-giomas of the facial bone. Plast Reconstr Surg 2006; 117(7): 2366−72.

Gomez Oliveira G, García-Rozado A, Luaces Rey R. Intraosseous mandibular hemangioma. A case report and review of the lite-rature. Med Oral Patol Oral Cir Bucal 2008; 13(8): E496−8.

Sun Z, Yang L, Yi C, Zhao H, Han D, Yang T, et al. Possibilities and potential roles of estrogen in the pathogenesis of prolife-ration hemangiomas formation. Med Hypotheses 2008; 71(2): 286−92.

Boyd JB, Mulliken JB, Kaban LB, Upton J, Murray JE. Skeletal changes associated with vascular malformations. Plast Re-constr Surg 1984; 74(6): 789−97.

Kaban LB, Mulliken JB. Vascular anomalies of the maxillofacial region. J Oral Mmaxillofac Surg 1986; 44(3): 203−13.

Eliot CA, Castle JT. Intraosseous hemangioma of the anterior mandible. Head Neck Pathol 2010; 4(2): 123−5.

Nakagawa Y, Kobayashi K, Ishii H, Mishima A, Ishii H, Asada K, et al. Preoperative application of limited cone beam computerized tomography as an assessment tool before minor oral surgery. Int J Oral Maxillofac Surg 2002; 31(3): 322−6.

Danforth RA. Cone beam volume tomography: A new digital imaging option for dentistry. J Calif Dent Assoc 2003; 31(11): 814−5.

Hatcher DC, Dial C, Mayorga C. Cone beam CT for pre-surgical assessment of implant sites. J Calif Dent Assoc 2003; 31(11): 825−33.

Brown J, Chatterjee R, Lowe D, Lewis-Jones H, Rogers S, Vaughan D. A new guide to mandibular resection for oral squamous cell carcinoma based on the Cawood and Howell classification of the mandible. Int J Oral Maxillofac Surg 2005; 34(8): 834−9.

Prein J, Remagen W, Spiessl B, Uehlinger E. Atlas of tumors of the facial skeleton: Odontogenic and nonodontogenic tumors. Berlin-Heidelberg: Springer; 1986.

Kalsi HK, Scannel J. Unusual presentation of an intraosseous haemangioma of the maxilla and displaced canine. Oral Sur-gery 2013; 6(2): 80−2.

Williams HJ, Wake MJ, John PR. Intraosseous haemangioma of the mandible: A case report. Pediatr Radiol 2002; 32(8): 605−8.

Valentini V, Nicolai G, Lorè B, Aboh IV. Intraosseous Heman-giomas. J Craniofac Surg 2008; 19(6): 1459−64.

Hansen T, Kunkel M, Katenkamp D, Eletr S, Wagner W. Heman-gioma of the mandible: Case report with special emphasis on bone degradation. Oral Maxillofac Surg 2009; 13(4): 239−42.

Wu J, Du J, Lu P, Chen C. Interdisciplinary management of mandibular intraosseous haemagioma. Br J Oral Maxillofac Surg 2011; 49(7): e55−7.

Alves S, Junqueira JL, Oliveira EM, Pieri SS, Magalhães MH, Dos Santos Pinto D, et al. Condylar hemangioma: Report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102(5): e23−7.

Greene AK, Rogers GF, Mulliken JB. Intraosseous "hemangi-omas" are malformations and not tumors. Plast Reconstr Surg 2007; 119(6): 1949−50.

Lowe LH, Marchant TC, Rivard DC, Scherbel AJ. Vascular mal-formations: Classification and terminology the radiologist needs to know. Semin Roentgenol 2012; 47(2): 106−17.

Ernemann U, Kramer U, Miller S, Bisdas S, Rebmann H, Breuninger H, et al. Current concepts in the classification, diagnosis and treatment of vascular anomalies. Eur J Radiol 2010; 75(1): 2−11.

Drage NA, Whaites EJ, Hussain K. Haemangioma of the body of the mandible: A case report. Br J Oral Maxillofac Surg 2003; 41(2): 112−4.

Zlotogorski A, Buchner A, Kaffe I, Schwartz-Arad D. Radiological features of central haemangioma of the jaws. Dentomaxillofac Radiol 2005; 34(5): 292−6.

Dreiseidler T, Alarabia N, Ritter L, Rothamel D, Scheer M, Zöller JE, et al. A comparison of multislice computerized tomography, cone-beam computerized tomo-graphy and single photon emission computerized tomography for the assessment of bone invasion by oral malignancies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112(3): 367−73.

Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IA. A new volumetric CT machine for dental imaging based on the cone-beam technique: Preliminary results. Eur Radiol 1998; 8(9): 1558−64.

Hendrikx AF, Maal T, Dieleman F, Van Cann EM, Merkx MW. Cone-beam CT in the assessment of mandibular invasion by oral squamous cell carcinoma: Results of the preliminary study. Int J Oral Maxillofac Surg 2010; 39(5): 436−9.

Moore SL, Chun JK, Mitre SA, Som PM. Intraosseous hemangi-oma of the zygoma: CT and MR findings. AJNR Am J Neuroradiol 2001; 22(7): 1383−5.

Perugini M, Renzi G, Gasparini G, Cerulli G, Becelli R. Intraosseous hemangioma of the maxillofacial district: Clinical analysis and surgical treatment in 10 consecutive patients. J Craniofac Surg 2004; 15(6): 980−5.

Landes CA, Stübinger S, Laudemann K, Rieger J, Sader E. Bone harvesting at the anterior iliac crest using piezoosteotomy ver-sus conventional open harvesting: A pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105(3): e19−28.

Degerliyurt K, Akar V, Denizci S, Yucel E. Bone lid technique with piezosur-gery to preserve inferior alveolar nerve. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108(6): e1−5.

Lemound J, Brachvogel P, Götz F, Rücker M, Gellrich N, Eckardt A. Treatment of mandibular high-flow vascular malformations: Report of 2 cases. J Oral Maxillofac Surg 2011; 69(7): 1956−66.