Combined Modality approach in the Management of Oral and Circumoral Haemangiomas with emphasis on use of absolute Ethyl Alcohol

Abstract

Although various modalities of treatment of haemangiomas including embolic therapy have been proposed, consideration of cost and technological requirements suggest that cheaper methods with less technological re-quirements need to be developed for use particularly in developing countries. The study objective was to de¬scribe the pattern of circumoral haemangiomas and explore the possible role of absolute ethyl alcohol in their management. It was a prospective study using hospital based study group at the University of Nairobi teaching and referral Dental Hospital. Of the 25 cases (24 females, 1 male) on follow-up, 68% had carvemous while 20% had capillary haemangiomas. The majority of the haem angiomas ranged in size from 2cm 2 - 31.5cm2. The lower lip was the most frequently affected (52%). None of the cases underwent spontaneous involution even after 10 years of follow-up. After intra lesions administration of alcohol, 3 cases of carvenous haeman¬gioma measuring 2cm2 and none of the capillary type underwent complete resolution. Other benefits of ethyl alcohol included better localization of the lesion and negligible intra and post operative haemorrhage for cases requiring surgery. Although pain and swelling for a few days were recorded in all cases and superficial tissue necrosis in two cases, there were no major alcohol-related complications. Therefore, Intra-lesion administra¬tion of absolute ethyl alcohol appears to be effective adjuvant to surgery and in addition may result in com¬plete resolution of small cavernous types of lesion. Spontaneous resolution of haemangiomas is not common in our set-up.