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Challenges in the management of massive intraorbital and hemifacial arteriovenous malformation as causing life-threatening epistaxis.

Research paper by Anura Michelle AM Manuel, Santhi S Kalimuthu, Sitra Siri SS Pathmanathan, Prepageran P Narayanan, Zurina Z Zainal Abidin, Khairul K Azmi, Alizan A Khalil

Indexed on: 12 Nov '13Published on: 12 Nov '13Published in: Asian Journal of Surgery



Abstract

Arteriovenous malformations are congenital lesions that may evolve with time and manifest in a plethora of presentations. They can occur as torrential epistaxis when it extensively involves the facial region. Multi-imaging modalities are available to assist in characterizing the structure of the lesion as well as its location and extent. This complex disease requires a multidisciplinary team approach with preoperative embolization and surgery. We present a rare cause of life-threatening epistaxis in a gentleman with a longstanding orbital and hemifacial arteriovenous malformation and discuss the complexities involved in its management.