Ear, Nose and Throat (Otolaryngology) – Head and Neck Surgery

Venous Malformations

Venous malformations (VM) are a type of vascular malformation. They are caused by a collection of enlarged veins that lack the normal, smooth muscle that typically lines their walls. The weakening of the walls allows the veins to stretch and enlarge over time. A VM can develop on any part of the body and are sometimes misdiagnosed in children as deep hemangiomas.

Venous malformations have a number of recognizable characteristics. For example, they may:

  • Develop in superficial or deep veins
  • Appear as a single lesion or as part of multiple lesions
  • Be soft, compressible and indent when pressed on
  • Be localized or spread throughout in multiple locations
  • Form on sites including the mouth, lips, tongue, cheek, side of the face, scalp, and neck
  • Swell and enlarge the affected area
  • Exhibit increased swelling when pressure in the veins rises during the valsalva maneuver (inhaling a breath and holding it tight) or when the affected area is lower than the rest of the body
  • Appear as blue or purplish lesions
  • Grow progressively and proportionately with the patient over time
  • Possibly recur

Early Intervention for Venous Malformations

Venous malformations are not curable. They grow and develop throughout the life of a patient and require observation and management to prevent growth, disfigurement, and functional problems.  A birthmark specialist should be consulted as soon as a VM is suspected. Venous malformations involving the tongue or other structures around the airway may cause problems with breathing or speaking. In addition, painful swelling can develop in patients whose VM is on the arms and legs.

Treatment Options for Venous Malformations

For most patients with venous malformations, early treatment through a combination of laser, surgical therapy, and/or sclerotherapy is recommended to minimize the progressive enlargement and subsequent deformity that occurs with untreated venous malformations.