Percutaneous Sclerotherapy for Facial Venous Malformations: Subjective Clinical and Objective MR Imaging Follow-Up Results

Twenty-two-year old patient with a large diffuse venous malformation of the right cheek and oropharynx, who presented with swelling leading to oral obstruction and obstructive sleep apnea. Both components of the lesion were treated. Presclerotherapy (A) and postsclerotherapy (B) fat-saturated axial T2-weighted MR images at similar levels of the maxilla show no significant change in the size of the cheek (white arrows) and intraoral (white arrowheads) portions of the lesion after 9 sessions. Despite this, the patient was extremely satisfied with treatment, noting a decrease in swelling and oral obstruction. He also appreciated an improvement in cosmetic aspects of the lesion, noting more symmetric facial contour subsequent to treatment. Additionally, the otolaryngologist who referred him noted a subsequent improvement in sleep disordered breathing. This decrease in lesion swelling likely represents a change in the physiology of the lesion, rather than its anatomy.