Oral hemangioma

Introduction

Introduction to oral hemangioma Oral hemangioma is a common benign tumor in the oral and maxillofacial region. Mostly congenital, it is caused by vascular endothelial proliferation. More common facial skin, subcutaneous tissue and oral mucosa (such as lips, tongue, cheeks, mouth, etc.). Generally can be divided into capillary hemangioma, cavernous hemangioma and vascular hemangioma. The two are common in the past. Hemangiomas are formed by the proliferation of a large number of capillaries in the mucosal layer. The buccal mucosa is a red or purple-red circular plaque, which is flat or slightly higher than the surface of the oral mucosa. The pressure is faded and the boundary is clear. Often caused by bruising mucous membranes when chewing food. Laser treatment of hemangioma is currently an ideal and effective method. In order to obtain good results, drug therapy must be applied after major hemangiomas, especially in the oral giant hemangioma. Therefore, after the application of antibacterial anti-inflammatory drugs and energy mixture, strict aseptic surgery during surgery to increase the amount of vitamin C (5 ~ 8g) and multi-cluster vitamin treatment for 1 to 2 weeks, without the need for antibiotics. After the operation without hormone therapy, the application of coagulant should be based on treatment considerations. Generally, laser treatment is usually closed in a closed manner, and the laser has a special effect of directly sealing the blood vessel, so there is very little bleeding, and it is not necessary to use a coagulant. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: non-infectious Complications: hemangioma

Cause

Oral hemangioma etiology

(1) Frequent rubbing, causing rupture of oral hemangioma: Most patients with capillaries and hemangioma are infants and young children. Because of the symptoms of itching in some capillary hemangioma, the child is not sensible and often scratches, causing The rupture of bleeding, as well as the growth of oral hemangioma in the hidden parts, clothing and other round-trip friction, causing ulceration and bleeding.

(2) irritative rupture and bleeding: Some children have oral hemangioma in the perineum or oral cavity, causing rupture and bleeding due to the stimulation of urination and saliva.

(3) due to improper treatment of rupture bleeding: due to limited treatment conditions, some places only laser, freezing and other methods of treatment, this type of treatment is originally a traumatic treatment, there will be a corresponding wound after treatment, So it will break the bleeding.

(4) Oral hemangioma in the oral cavity of adults due to chewing caused by ulceration: adult oral hemangioma grows in the oral cavity, because the early treatment is not effective, the area is getting larger and larger, resulting in limited chewing function, unconsciously It is bitten and causes ulceration, which is unconscious.

Prevention

Oral hemangioma prevention

Hemangiomas are caused by congenital vascular malformations. Pay attention to light diets and taboo spicy foods in daily life.

Complication

Oral hemangioma complications Complications

Oral hemangioma hazard

Because oral hemangioma grows in the mouth, it will seriously affect the patient's diet and psychology, so it should be treated as soon as possible to end this unnecessary pain. In addition, some hemangioma may suddenly rupture, causing fatal bleeding. Such hemangioma should also seek medical advice promptly, choose the best treatment method and timing, and choose appropriate treatment for treatment when fully prepared. Significantly reduce the risk of treatment.

Symptom

Oral hemangioma symptoms Common symptoms Vascular malformation Nodular sclerosis erythema (clear boundary

(1) Capillary hemangioma : An aneurysm is formed by the proliferation of a large number of capillaries in the mucosal layer, which is characterized by a red or purple-red circular plaque on the buccal mucosa, which is flat or slightly higher than the surface of the oral mucosa, and the color is faded. The boundary is clear. Often caused by bruising mucous membranes when chewing food.

Capillary hemangioma can also occur in deep tissues, such as masseter muscles and parotid glands. The boundary is unclear, the surface skin color is normal, the palpation is hard, incompressible, and the puncture can extract a small amount of blood. Masseter muscle capillary hemangioma, when the upper and lower jaws are forced to bite, the mass rises and disappears after relaxation.

(2) Cavernous hemangioma : a common tumor in the mouth, composed of most capillaries and sinusoids. The size and shape of the sinusoids are different. The sinus veins communicate with each other. For example, the sponge structure is lined with endothelial cells, sometimes there are thrombus in the sinus, and vein stones are formed by calcium salt deposition. Occurred in the submucosal and subcutaneous of the oral cavity, it can invade the muscles invading the surrounding tissues. The subcutaneous tissue tumors protrude to the mouth and face. The enlargement of the tumor causes the facial deformity to affect eating. Sometimes, when chewing, the mucosa of the hemangioma causes bleeding. Cavernous hemangioma is mostly single or multiple. If the lesion is deep, the color of the oral mucosa is normal. For example, when the lesion is in the superficial layer of the mucosa, the mucosa is purple-blue, and the soft capsule of the sputum is compressive. After the pressure was relieved, the seeds quickly returned to normal. The boundaries around the tumor are unclear, and most of them have no envelope.

(3) Mixed hemangioma: has the pathological and clinical features of capillary hemangioma and cavernous hemangioma, showing that the buccal mucosa is red or purple, and the oval plaque is higher than the mucosal surface, showing a hilly or nodular shape. Uplift, the soft pressure is reduced, the boundary of the tumor is unclear, and because the buccal tumor affects chewing, it is often bitten by a shallow capillary hemangioma, causing bleeding.

Examine

Examination of oral hemangioma

Hemangiomas with deeper positions should be determined by positional movement tests and punctures. For vascular hemangioma and cavernous hemangioma in deep tissue, angiography and angiography or magnetic resonance angiography are used for assistance and for reference. The results of laboratory tests were not found. For the more superficial, the tumor is more limited to examine the project to check the frame limit "A". For those who have deeper disease at the site or the tumor is large, the examination plan may include the check boxes "B" and "A".

X-ray radiographs of the neck are useful for understanding the size, extent, or whether the tumor is eroding the cervical or laryngeal cartilage. If an angiogram is performed before surgery, the nutritional branch of the hemangioma can be understood, and the blood vessels can be ligated at both ends of the hemangioma, which can reduce intraoperative bleeding and facilitate the complete removal of the hemangioma.

Diagnosis

Diagnosis and diagnosis of oral hemangioma

diagnosis

The diagnosis of oral hemangioma should be confirmed according to the symptoms of each hemangioma combined with CT, B-ultrasound and other examination methods.

Differential diagnosis

Different from glomus tumors and angiosarcomas, the characteristics are as follows:

1. glomus tumor: a sharp painful mass in the finger, toenail bed and its vicinity. The pain is especially painful during cold stimulation. Located under the armor, visible fingernails, local toe of the toenail, the surface can be light red, purple or slightly dark, more than touch.

2. Angiosarcoma: less common, the tumor is nodular, painless, purple red, superficially easy to bleed and ulceration. Under the microscope, many disordered tumor blood vessels are seen. The tumor cells proliferate in the basement membrane and can be attached to the inner wall of the blood vessel to form a nodular protrusion in the lumen. The tumor cells are mostly fusiform, and the undifferentiated ones are polygonal, endothelium-like, with large nuclei, deep staining, and more nuclear division. Polynuclear giant cells can be seen.

Immunohistochemistry is important for the diagnosis and differential diagnosis. Sensitive endothelial markers, VIII-related antigens, CD31, CD34, etc. can be selected to help determine the diagnosis.

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