目的

探讨婴幼儿腮腺咬肌区静脉畸形的无创治疗方法及其疗效。

方法

采用平阳霉素局部注射治疗婴幼儿腮腺咬肌区静脉畸形19 例，隔周1 次，连续4 次为1 个疗程。1 个疗程不能治愈者，间隔1 周开始第2 疗程治疗。 记录病变转归和不良反应，追踪随访，评价疗效。

结果

经过3 ～8 次局部注射，16 例患儿完全治愈，腮腺咬肌区病变消退，表面皮肤色泽正常。 注射期间未见局部溃疡，无过敏病例。 随访1 ～3 年，未见复发，无瘢痕形成及面神经损伤症状。3 例病变范围较大的患儿，注射1 疗程后因疗效不显著，分别改行手术或翻瓣激光联合平阳霉素腔内注射治疗，随访可见手术瘢痕，腮腺咬肌区轻度凹陷畸形，手术治疗的1 例出现面神经损伤症状，3 例均无复发。

结论

平阳霉素局部注射治疗婴幼儿腮腺咬肌区静脉畸形治愈率高，不遗留瘢痕，不损伤面神经，是值得推荐的治疗方式。 但对大范围的静脉畸形疗效较差，需配合其它治疗。

Objective

To investigate non-traumatic method for treatment of infantile venous malformation located in parotid masseteric regions， and to evaluate its clinical effect.

Methods

Nineteen patients were treated by intralesional injections of Pinyangmycin. The processes were repeated at an interval of one week， but not more than 4 injections within a treatment period. In case of necessary， the secondary period was performed 2 weeks later. The general and local adverse responses were recorded and the clinical outcomes were followed-up from 1 to 3 years.

Results

Complete clinical resolutions were achieved in 16 patients after 3 to 8 injections. The venous malformations disappeared and were replaced by normal skins. No ulceration or allergy was found during the treatment. No clinical recurrence or scar was observed through out follow-up. The functions of facial nerve were remained normally in all patients. 3 patients with huge venous malformations received surgical management or laser therapy combined with sclerotherapy after 4 injections for their poor clinical results. Operative scars and slight depression deformities in parotid gland regions were observed in 3 patients. Symptoms of facial nerve damage appeared in infant receiving operative treatment. No recurrence was found in all cases as well.

Conclusions

Treatment of infantile venous malformation in parotid gland region with intralesional injections of pinyangmycin revealed a high rate of complete clinical resolution，and did not damage facial nerve or form facial scar. It could be regarded as an effective and nontraumatic therapeutic method for infantile venous malformations in parotid masseteric regions.Comprehensive treatments might be employed in huge lesions.