Evaluation of treatment outcomes in children with maxillofacial vascular tumors: Cohort study

Abstract

Background. The variety of the clinical features of vascular tumors in the maxillofacial area limits the choice of method and is able to make difficulties in the treatment. The combined method of treatment proposed by the authors (vascular sclerotherapy with concurrent propranolol intake) demonstrates high efficacy, lack of invasiveness, shortening the rehabilitation period and less side effects. Objective. The aim of the study was to increase the effectiveness of conservative treatment of vascular tumors of the maxillofacial area in young children by combining the method of sclerotherapy and taking proprono-lol. Methods. In a cohort study, the results of treatment of 80 children aged 2 months to 2 years with vascular tumors of the maxillofacial region (ICD-10: D18.0) were evaluated. A comparison was made of the results in 2 groups of children who were treated with different methods: combined (n =40; main group; sclerotherapy and taking propranolol) and propranolol monotherapy (n =40; comparison group). Analysis of the data obtained in the main group and the comparison group led to the development of the criteria for evaluating the treatment results: good (regression of vascular tumors and the absence of a cosmetic defect), satisfactory (reduction of vascular tumors by 2/3 or more with maintaining cosmetic defect) and unsatisfactory (gross cosmetic defect) in terms of changes in the volume of tumor, the diameter of the supply vessels and the values of the linear velocity of blood flow according to ultrasound data. Results. Subjects treated by the combined treatment had a significant regression of vascular tumors in the maxillofacial area compared with the comparison group: reduction of the tumor volume, diameter of the supply vessels and linear blood flow velocity according ultrasound data reached zero after 6 months from the start of combined treatment — 6 months earlier than in the comparison group (p <0.001). Conclusion. According to the results of the study, the advantage of the author’s method over the traditional method was demonstrated, which resulted in a reduction in the duration of treatment, a decrease in the risk as well as in a degree of complications. © 2019 Paediatrician Publishers, LLC. All rights reserved.