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Ear, nose and throat
Tumescent solution: a game changer in excising refractory arteriovenous malformation
  1. Ramkumar Rethinasamy,
  2. Lokesh Kumar Penubarthi,
  3. Dharanya Gopalakishnan Srinivasan and
  4. Arun Alexander
  1. Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Lokesh Kumar Penubarthi; Lokesh86p{at}gmail.com

Abstract

Arteriovenous malformations of the head and neck are rare and inborn errors of vascular morphogenesis. They pose therapeutic challenges owing to their bleeding tendency and a high chance of recurrence. Treatment modalities include digital subtraction angiography with embolisation as a primary treatment or can be done preoperatively followed by surgical excision. We present a case of recurrent arteriovenous malformation of the postauricular region in an adolescent male who was taken up for upfront surgical excision with the help of a tumescent solution, thereby eliminating the need for embolisation and drastically reduced intraoperative blood loss.

  • ear, nose and throat/otolaryngology
  • otolaryngology / ENT
  • drug therapy related to surgery
  • vascular surgery

https://doi.org/10.1136/bcr-2023-257483

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: (1) substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work: RR, LKP, DGS and AA. (2) Drafting the work or revising it critically for important intellectual content: LKP. (3) Final approval of the version to be published: AA. (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The following authors gave final approval of the manuscript: LKP and AA.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.