Neurological Surgery No Shinkei Geka Volume 45, Issue 4 (April 2017)

A Case of Arteriovenous Malformation of the Parotid Gland Associated with Cowden Disease Kazuhiko NISHI 1 , Satoshi MURAI 1 , Hisakazu ITAMI 1 , Shinji OTSUKA 1 , Noboru KUSAKA 1 , Tsukasa NISHIURA 1 , Nobuhiko KIMURA 2 , Kotaro OGIHARA 1 1Department of Neurosurgery, National Hospital Organization Iwakuni Clinical Center 2Department of Otolaryngology, National Hospital Organization Iwakuni Clinical Center Keyword: arteriovenous malformations , parotid gland , Cowden disease , surgical treatment , vasa nervorum feeder pp.333-338
Published Date 2017/4/10
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 We report a rare case of arteriovenous malformation(AVM)of the parotid gland associated with Cowden disease successfully treated with preoperative embolization followed by surgical removal. A 39-year-old man with a history of Cowden disease presented with a pulsating and growing mass on his left lower jaw. Contrast-enhanced computed tomography(CT)and angiography revealed a high-flow AVM in the deep lobe of the left parotid gland.

 After intravascular embolization of the feeding arteries, surgery was performed using the NIM-response®3.0, facial nerve monitoring system. The AVM was almost completely removed and the facial nerves were morphologically preserved. Interestingly, the intraoperative findings revealed that the enlarged vasa nervorum of the facial nerve also fed the AVM. Although left facial nerve palsy appeared after the surgery, the nerve function gradually improved over one year. No recurrence of the AVM has been observed for one year.

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Neurological Surgery 脳神経外科
45巻4号 (2017年4月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院