Efficacy and safety of portable ultrasound-guided pingyangmycin sclerotherapy for deep-seated oral and maxillofacial venous malformations: a retrospective observational study

Objective Intralesional sclerotherapy is the mainstay treatment for venous malformations (VMs). This study aimed to assess the efficacy and safety of ultrasound-guided pingyangmycin sclerotherapy for outpatients with deep-seated oral and maxillofacial VMs. Methods This retrospective study included 49 outpatients with symptomatic deep-seated VMs in the oral and maxillofacial region who received portable ultrasound-guided pingyangmycin sclerotherapy between August 2023 and September 2025. The treatment response analysis after sclerotherapy included lesion volume reduction and symptom improvement. Ultrasound was used to calculate lesion volume. The assessment of global discomfort from the perspective of patients was calculated using the 0–10 numeric rating scale (NRS). The presence of complications was recorded during follow-up. Results Among the 49 patients, the average number of sessions for each patient was 2 (range, 1–5). All patients experienced symptom relief after sclerotherapy. The median post-treatment NRS score was 0 (range, 0–1), compared with a median of 5 (range, 2–10) before sclerotherapy. Regarding lesion volume, twenty-one lesions (42.86%) demonstrated excellent response (≥90% reduction). Twenty-three lesions (46.94%) presented moderate response (≥50, <90% reduction). Five (10.2%) lesions showed mild reduction (<50% reduction). The mean lesion dimensions after treatments were 1.54 × 0.87 × 0.96 cm, with a corresponding calculated volume of 0.47 cm 3 , compared with average dimensions 3.27 × 1.69 × 1.85 cm (volume, 3.59 cm 3 ) before sclerotherapy. A mean volume decrease of 82% was observed among all patients. Paired analysis showed significant improvement in both lesion volume and NRS score after the sclerotherapy. No severe complications occurred in this study. Conclusion Portable ultrasound-guided pingyangmycin sclerotherapy is a feasible and well-tolerated outpatient-based procedure for patients with deep-seated oral and maxillofacial venous malformations.