Vascular lesions of the oral and maxillofacial region are as challenging to clinicians as they are devastating to patients. Two basic entities of hemangioma and vascular malformations exist as vascular lesions. The differential diagnosis bfetween
these
two lesions can be done through the history and the phyisical findings. Some lesions may be difficult to evaluate; therefore, a diagnostic angiography may be employed. Management of maxillofacial vascular malformations consists of sclerotherapy,
cryotherapy, radiotherapy, intralesional ligation, embolotherapy, laser therapy, and surgical treatment. The surgical management of vascular malformations, particularly the arteriovenous malformation, remains as controversial an issue as any in
contemporary oral and maxillofacial surgery. On one hand, there is a surgically aggressive school of thought that advocates major segmental or en bloc resecton of the arteriovenous malformation. The opposite point of view is clearly reflected by
the
numerous case reports that appear in the literature of arteriovenous malformations managed by simple curettage.
We experienced a large mandibular arteriovenous malformation with an intact buccal cortex that was treated with curettage with the lateral decortication and reposition of the decorticated buccal bone plate after preoperative embolization using
Gelfoam
and without arbitrary sacrifice of the uninvolved cortical margin that could provide stability of the mandibular arch. The postoperative result was good aesthetically and functionally.
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