Treatment of Oral and Perioral Benign Vascular Lesion with Ethanolamine Oleate: A Systematic Review

Background: Benign oral vascular lesions are abnormalities defined by the proliferation or malformation of blood vessels. The appearance of vascular lesions varies according to age and anatomical location. There are no criteria to evaluate its therapeutic effectiveness. Treatment with the sclerosing drug ethanolamine oleate irrigates the vessel, causing a sterile inflammatory response. Objectives: This article provides an overview of the effectiveness and complication of ethanolamine oleate in the management of oral and perioral benign vascular lesion. Methods: This article is based on a comprehensive literature search, identifying relevant articles using Ovid, PubMed, and Google Scholar. The data mainly involve a critical review of various studies from sample groups of different ethnicities, age groups, and gender, were evaluated. Findings: Hemangiomas and vascular malformations are among the many disorders that can cause vascular lesions of the head and neck. When vascular lesions are producing pain or symptoms, they need to be treated. Systemic and intralesional steroids, intralesional sclerosing drugs, interferon, laser therapy, embolization, cryotherapy, and radiation are some of the therapeutic approaches and techniques that have been suggested for the treatment of vascular lesions. As a primary amine and a primary alcohol, ethanolamine oleate is an organic chemical molecule that, when injected into tissues, can result in a dose-related inflammatory response that causes fibrosis and a reduction in the size of lesions. The most affected age group was between 41 and 70 years (mean age: 47 years, range: 4-87 years). The female gender was predominant (56%), and 86% of patients were Caucasian. Half of the patients reported the presence of a lesion (complaint period) lasting longer than 5 years. Regarding the location, there was a higher rate of occurrence on the lips (70%) followed by the tongue (16%) and buccal mucosa (14%). According to the clinical appear­ance of the lesions, approximately 90% were classified as nodules. A total of 41% of the lesions were between 0.5 cm and 1.0 cm in size (Table 1). Swelling was the most common type of complaint, reported by 28 patients (65%) followed by color alteration (7 patients, 16%). Most patients reported no pain (90%). Con­cerning the clinical diagnostic hypothesis, 40 lesions were defined as hemangiomas and vascular malforma­tions (93%) and 3 as varices (7%). Only one session of one application of 5% EO was suf­ficient to obtain a satisfactory result in 58% of the pa­tients. The regression of the lesions usually occurred in 2 to 3 weeks after the application. Regarding the lesions larger than 1.0 cm, 6 cases received a total dose of 0.4 to 0.7ml of EO, 9 cases received 0.8 to 2.0 ml, and 4 cases received more than 2.0 ml. Conclusion: Ethanol Amine Oleate Sclerotherapy is a less intrusive and safe technique that is simple to repeat and poses little risk to the patient. Some individuals may experience procedure-related side effects, such as induration, edema, discomfort, and cutaneous or mucosal blisters at the injection site. These issues are mild, though, and should go away in three to four days.