Arteriovenous malformation (AVM) in the maxillofacial region is a rare, but potentially life-thereatening vascular lesion. Although AVM is usually diagnosed on angiography, the procedure is very invasive. We report the identification of AVM and feeding vessels on three-dimensional CT angiography (3D-CTA), which is minimally invasive.
A 21-year-old man with a right buccal swelling was referred to our hospital. AVM was diagnosed on the basis of clinical signs and examinations such as ultrasonography, MR imaging, MR angiography, and CT. Angiography was not done. The vascular lesion was fed by two arteries (facial artery and infraorbital artery) in the right buccal region, clearly demonstrated on 3D-CTA. The patient underwent resection of the lesion and simultaneous reconstruction with a local flap. There was no evidence of recurrence 6 months after surgery.
Three-dimensional CTA can identify feeding vessels and assess the extent of AVM. This method is useful for surgical planning, as well as preoperative diagnosis.