Arteriovenous Malformation Presenting as a Disfigured and Throbbing Face: Case Report

Authors

Abrar Shamim DDS, Oral and Maxillofacial Surgery Resident, Massachusetts General Hospital/Harvard Medical SchoolFollow
Steven Halepas DMD, MD, Graduate of the Oral and Maxillofacial Surgery Residency Program, New York-Presbyterian/ Columbia University Irving Medical CenterFollow
Alfonso Salcines DMD, MD, Graduate of the Oral and Maxillofacial Surgery Residency Program, New York-Presbyterian/ Columbia University Irving Medical CenterFollow
Sidney B. Eisig DDS, FACS, Chair, Division of Oral and Maxillofacial Surgery, New York-Presbyterian/ Columbia University Irving Medical CenterFollow

Keywords

arteriovenous malformation, mandible, oral pathology

Abstract

Maxillofacial arteriovenous malformations (AVMs) are a rare condition in which arteries and veins are in continuity without a capillary bed in between, which poses a significant risk of severe bleeding. Intraosseous AVMs can lead to cortical bone expansion and facial deformity. Dental procedures may result in life-threatening bleeding risk if this condition is not recognized. This report describes a patient experiencing pain in the lower right side of the mouth, along with a taste of blood in the mornings and a tingling sensation in the chin and lower lip. The patient had a history of uncontrolled bleeding following a dental extraction at an adjacent site. Examination demonstrated a non-fluctuant facial enlargement, with pulsation on extraoral palpation of the mandible and buccal and lingual vestibules intraorally. CT angiogram confirmed an intraosseous AVM with multiple feeder vessels. The patient underwent preoperative embolization to minimize intraoperative bleeding followed by a hemimandibulectomy and a fibula free-flap reconstruction.

Recommended Citation

Shamim, Abrar DDS; Halepas, Steven DMD, MD; Salcines, Alfonso DMD, MD; and Eisig, Sidney B. DDS, FACS (2025) "Arteriovenous Malformation Presenting as a Disfigured and Throbbing Face: Case Report," The New York State Dental Journal: Vol. 91: No. 2, Article 6.
Available at: https://commons.ada.org/nysdj/vol91/iss2/6