Avaliação do tratamento de malformações vasculares benignas de baixo fluxo por meio de escleroterapia com oleato de monoetanolamina

Abstract

The objective of this study was to evaluate the efficacy and safety of the sclerosing agent monoethanolamine oleate (MO) in concentrations of 1.25%, 2.5%, 5% and in the form of foam descriptive prospective clinical study in the treatment of benign vascular lesions (BVLs) in the head and neck. In the first phase, we treated 34 patients with 36 smaller than 20 mm BVLs who sought the Pathology Clinical of the School of Dentistry (UFMG). These patients received treatment protocol application OM inconcentrations of 1.25% (n = 10), 2.5% (n = 9) described by Johann et al (2005) and 5% (n = 19) in doses 1ml / cm,1ml / cm and 0.1 ml / 3mm respectively. Inittialy the group treated by OM 5%, which involved 19 patients and 15 LVBs, divided into two groups (G1 = 6.5 mm and G2 = 6,5mm) and were evaluated for: 1) Healing Clinical second Achauer et al., (1997), 2) pain / burning second Manionn et al., (2007), 3) edema according to Amaral et al., (2012), 4) the use of analgesic, 5) ulcer, 6) functional changes postoperatively (chewing and speech), 7) bleeding, 8) hematoma, 9) infection, 10) scar, 11) resolution time 12) satisfaction seconds Penarrocha et al., (2007) 13) recurrence. Data were analyzed by EPI INFO 7 program (Center for disease Control and Prevention- CDC). The most frequent site was the lower lip (n =7). Pain and swelling were reported respectively by 90% and 100% of patients. It did not occur complications and was not reported use of analgesics. The clinical healing has occurred in 100% of BVLs. At follow-up there was no recurrence. The satisfaction rate was 9 on average. In the second part of the study was performed comparing the OM concentrations 1.25%, 2.5% and 5% of the number of sessions and the final volume applied in sclerotherapy treatment, using the SPSS 18.0 Software (SPSS Inc.,Chicago, IL), there was statistical difference with p < 0.003 and p <0.001 (Kruskal-Wallis test - Mann Whitney- Bonferroni correction) respectively, demonstrating less final volume applied to the concentration of OM to 5% and consequently the number of treatment sessions for OM was lower than 5%, showing healthy and balanced between the three security levels and superior efficacy OM 5% concentration. In the third stage, treated 17 patients with 34 BVLs who sought the Endovascular Surgery Outpatient Clinic of the Clinical Hospital. These patients received treatment protocolimplementation OM Foam 5% at a concentration of 1 ml / 1cm of lesion. The same parameters were evaluated. The most frequent site was the tongue (n = 8). Pain and swelling were reported by 100% of patients. Superficial necrosis occurred in 9 patients.Patients reported no use of painkillers. Healing of the lesions occurred in 85%. At 6 months follow-up there was no recurrence. The satisfaction rate was 9 on average. Fisher's exact test showed statistical differences in the size variables ( 30mm and 30mm) against total dose, number of sessions and clinical cure (p < 0.0002; p < 0.04; p <0,01respectivamente) and Compared satisfaction ( 9.5 and 9,5) with clinical cure (p < 0.0003). Thus, OM foam was safe and effective in treating BVLs.