Abstract / Summary
High-flow Arteriovenous Malformations (AVM) of the auricular region is rare but difficult-to-treat vascular anomalies. As a benign entity, management of the lesion should balance aesthetic considerations, long-term function, and the avoidance of life-threatening complications. A 35-year-old male presented to the emergency department in shock with pulsatile bleeding from the left ear, following a history of progressive swelling and recurrent spontaneous haemorrhages from the left auricular region. On examination, a bruit could be heard, suggesting a high-flow AVM, and the patient was adequately resuscitated with blood products. Magnetic Resonance Angiography (MR Angiography) was suggestive of an enlarged external carotid artery with an extensive AVM around the left auricular and temporal region. A multidisciplinary team comprising plastic surgeons, interventional radiologists, surgical oncologists, and vascular surgeons reviewed the case and decided on surgical excision as the best course of action. Surgical extirpation was successfully performed along with external carotid artery ligation to control the haemorrhage with the defect being reconstructed using split thickness grafts. The patient has been on follow-up for two months with no evidence of disease recurrence. Rare locations of high-flow AVMs should always be discussed with a multidisciplinary team to determine the best course of action among the available options for the patient.