Hostname: page-component-6766d58669-zlvph Total loading time: 0 Render date: 2026-05-24T20:49:00.186Z Has data issue: false hasContentIssue false
  • English
  • Français

Ear arteriovenous malformation: an algorithm for management

Published online by Cambridge University Press:  29 July 2025

Komala Abhishek Reddy Open the ORCID record for Komala Abhishek Reddy [Opens in a new window] ,
Ashish Kumar Gupta  and
Jonathan Victor
Komala Abhishek Reddy*
Affiliation:
Department of Plastic Surgery, Christian Medical College, Vellore, India
Ashish Kumar Gupta
Affiliation:
Department of Plastic Surgery, Christian Medical College, Vellore, India
Jonathan Victor
Affiliation:
Department of Plastic Surgery, Christian Medical College, Vellore, India
*
Corresponding author: Komala Abhishek Reddy; Email: karonline@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Ear arteriovenous malformation is a complex problem with a lack of data and a clear consensus on its management. This paper aims to develop an algorithm for protocol-based ear arteriovenous malformation management.

Method

All patients underwent pre-operative discussions at a multi-disciplinary team meeting to plan excision and pre-operative embolisation.

Results

Nineteen patients were included in this study. Following excision, 26.3 per cent of cases had flap cover, 10.5 per cent needed a skin graft, 15.3 per cent had total amputation of the ear, and the rest underwent excision of the arteriovenous malformation with or without cartilage excision and primary closure. Recurrence was observed in 10.5 per cent of cases.

Conclusion

Surgical excision is the treatment of choice for ear arteriovenous malformations. Cartilage should be preserved whenever possible. The wound cover should be either a primary closure or a flap cover. A protocol-based guide facilitates decision-making of this complex problem.

Keywords

Ear deformityVascular malformationsAngioembolizationOtoplastyEar amputation

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 11 , November 2025 , pp. 1102 - 1108
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Whitty, LA, Murray, JD, Null, WE, Elwood, ET, Jones, GE. An arteriovenous malformation of the external ear in the pediatric population: a case report and review of the literature. Can J Plast Surg 2009;17:21–4CrossRefGoogle ScholarPubMed
Doppman, JL. The nidus concept of spinal cord arteriovenous malformations. A surgical recommendation based upon angiographic observations. Br J Radiol 2014;87:20130768Google Scholar
Kohout, MP, Hansen, M, Pribaz, JJ, Mulliken, JB. Arteriovenous malformations of the head and neck: natural history and management. Plast Reconstr Surg 1998;102:643–54CrossRefGoogle ScholarPubMed
Sisk, BA, Kerr, A, King, KA. Factors affecting pathways to care for children and adolescents with complex vascular malformations: parental perspectives. Orphanet J Rare Dis 2022;17:234CrossRefGoogle ScholarPubMed
Liu, AS, Mulliken, JB, Zurakowski, D, Fishman, SJ, Greene, AK. Extracranial arteriovenous malformations: natural progression and recurrence after treatment. Plast Reconstr Surg 2010;125:1185–94CrossRefGoogle ScholarPubMed
Potts, MB, Zumofen, DW, Raz, E, Nelson, PK, Riina, HA. Curing arteriovenous malformations using embolisation. Neurosurg Focus 2014;37:E19CrossRefGoogle Scholar
Ayahao, FD. Feeding and draining vessel ligation with sclerotherapy of high-flow arteriovenous malformations in the head and neck. Philipp J Otolaryngol Head Neck Surg 2014;29:6–10CrossRefGoogle Scholar
Rane, S, Lamba, S, Gohil, A, Gupta, A. Compendium of scalp arteriovenous malformation (AVM) cases—a retrospective study and review. Eur J Plast Surg 2018;41:195–201CrossRefGoogle Scholar
Bhandari, PS, Sadhotra, LP, Bhargava, P, Bath, AS, Mukherjee, MK, Maurya, S. Management strategy for facial arteriovenous malformations. Indian J Plast Surg 2008;41:56–63CrossRefGoogle ScholarPubMed
Pompa, V, Valentini, V, Terenzi, V, Villani, C, Cassoni, A, Iannetti, G. Treatment of facial vascular malformations with embolisation and surgical resection. Eur Rev Med Pharmacol Sci 2012;16:173–8Google ScholarPubMed
Deng, W, Huang, D, Chen, S, Zhang, X, Li, X, Li, J, et al. Management of high-flow arteriovenous malformation in the maxillofacial region. J Craniofac Surg 2010;21:1354–7CrossRefGoogle ScholarPubMed
Zou, Y, Qiao, C, Hua, C, Yang, X, Wang, T, Jin, Y, et al. Intralesional interstitial injection of bleomycin for management of extracranial arteriovenous malformations in children. Chin J Plast Reconstr Surg 2021;3:82–8Google Scholar
Strassmair, M, Wilhelm, K. Recurrence of idiopathic arteriovenous malformation of the finger. A case report [in German]. Orthopade 2001;30:162–5CrossRefGoogle ScholarPubMed
Mitchell, EL, Taylor, GI, Houseman, ND, Mitchell, PJ, Breidahl, A, Ribuffo, D. The angiosome concept applied to arteriovenous malformations of the head and neck. Plast Reconstr Surg 2001;107:1247–63CrossRefGoogle ScholarPubMed
Maftei, N, Howard, A, Brown, LC, Gunning, MP, Standfield, NJ. The surgical management of 73 vascular malformations and preoperative predictive factors of major haemorrhage – a single centre experience. Eur J Vasc Endovasc Surg 2009;38:522–7CrossRefGoogle ScholarPubMed
Richter, GT, Suen, JY. Clinical course of arteriovenous malformations of the head and neck: a case series. Otolaryngol Head Neck Surg 2010;142:184–90CrossRefGoogle ScholarPubMed
Vilela Chagas Ferreira, M, Goldenberg, DC, Kharmandayan, V, Gemperli, R. Management of arteriovenous malformation of the ear: a protocol for resection and reconstruction. Laryngoscope 2020;130:276–82CrossRefGoogle Scholar
Linh, DTN, Khanh, L, Dung, LT, Ha, NH, Son, TT, Duc, NM. Recurrence after treatment of arteriovenous malformations of the head and neck. AIMS Med Sci 2022;9:228–37CrossRefGoogle Scholar