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Tackling Vascular Malformations

Gregory M. Levitin, MD

Managing Vascular Malformations: Laser and Surgical Therapy
10:00 am, Today
Room 394

Eighteen years ago, one of the twin daughters of Gregory M. Levitin, MD, was born with a vascular birthmark that required her to undergo three surgeries.

“That experience has greatly influenced my own practice and how I treat my patients, and is a big part of why I continue to work as hard as I do to provide the best and most effective treatment for my patients,” said Dr. Levitin, with the Icahn School of Medicine at Mount Sinai and also lead presenter for today’s Expert Series.

Vascular malformations consist of port-wine stains, venous malformations, lymphatic malformations, and arterio-venous malformations.

“The main reason this is so important to the otolaryngologist is that 80 percent of these occur within the head and neck area, highlighting the important role for the otolaryngologist in diagnosing, managing, and/or coordinating the treatment for these conditions,”
Dr. Levitin said.

As for improved treatment options for vascular malformations, he said, “Technology is winning. We have developed better lasers, better science, and safer procedures to begin to tailor and individualize our treatment for vascular malformations.”

In the past, vascular malformations were often managed by interventional radiologists, and patients would undergo several—if not dozens—of invasive sclerotherapy/embolization procedures that many times didn’t adequately treat these conditions.

“Now, as a birthmark specialist, I can offer each patient a wide range of treatment options, often combining the best and appropriate use of medical, laser, and surgical therapy to achieve results better than ever before,” he said.

Dr. Levitin said he has been surprised by the significant progress that has been made thanks to better understanding the cause and genetic traits for each of these conditions.

“Until just 20 years ago, we didn’t have a system of classification or diagnosis; often every vascular birthmark was called a ‘hemangioma,’” he said. “Now, we have a full understanding of the biologic nature and behavior of each type of malformation. From this understanding, we can ensure a proper diagnosis and determine the most appropriate treatment options for each patient.”

Vascular anomalies are not common, but are commonly misdiagnosed, Dr. Levitin said. The treatment of each of these conditions depends on the area involved and the degree of disturbance or disfigurement.

“Nearly half of my patients who present with vascular malformations have been misdiagnosed and/or mismanaged, often having undergone unnecessary treatment,” he said. “By developing a better understanding of vascular malformations, the general otolaryngologist can take this information and be able to make the correct diagnosis, which in turn ensures better safety and patient care.”