The congenital arteriovenous fistula may be difficult to manage. To better understand this problem, we have categorized these various anomalies embryologically into the endothelial, retiform, and gross stages of differentiation. Embolization of the congenital fistula has not been fruitful in our hands. The reasons for this are explored and the suggestion of total extirpation of the region is entertained. We have also elected to manage an anomaly we call the nonfistulous or microfistulous vascular malformation with laminated calcification nonoperatively in order to see whether they will become macrofistulas in time.
Rappaport L, Yim D. Congenital Arteriovenous Fistulas of the Head and Neck. Arch Otolaryngol. 1973;97(4):350–353. doi:10.1001/archotol.1973.00780010360015
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