Spontaneous Regression Of Parapharyngeal Arteriovenous Malformation
Tseng, W. K., Su, I. C., Chen, M. T., & Lee, J. J. (2018). Spontaneous Regression of Parapharyngeal Arteriovenous Malformation. Vascular and endovascular surgery, 52(4), 313–315. https://doi.org/10.1177/1538574418761982
View Original Source →Abstract
Arteriovenous malformations (AVMs) are fast-flow vascular malformations that mostly occur in the head and neck region. They are typically progressive and their spontaneous regression is almost never seen. We present a case with pulsatile tinnitus and a parapharyngeal AVM. It resolved completely after diagnostic catheter-based angiography alone.
Case Details
Disease Location
Retropharyngeal space
Personal Characteristics
46-year-old woman, on oral contraceptive pills (ocps) for 16 years
Clinical Characteristics
Experienced an episode of pulsatile tinnitus. Six months later, computed tomography of the head and neck revealed a left parapharyngeal avm. Angiography revealed an avm supplied by the distal branches of the left maxillary artery and predominantly by the artery to foramen rotundum and possibly the accessory meningeal artery. Trans-arterial embolization and sclerotherapy were scheduled
Remission Characteristics
The tinnitus resolved after the diagnostic angiography. One month later, another angiography showed obliteration of the avm without any evidence of the previously visualized feeding vessel
Treatment & Mechanisms
Proposed Remission Mechanisms
Sudden cessation of ocp would have induced a state of hormonal withdrawal, which could be a reason for the shrinking of the avm and, subsequent, total regression.
Clinical Treatment
Angiography