{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T17:27:14Z","timestamp":1772645234747,"version":"3.50.1"},"reference-count":19,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["82272288"],"award-info":[{"award-number":["82272288"]}]},{"name":"National Natural Science Foundation of China","award":["82472577"],"award-info":[{"award-number":["82472577"]}]},{"name":"National Natural Science Foundation of China","award":["2023ZZ02023"],"award-info":[{"award-number":["2023ZZ02023"]}]},{"name":"National Natural Science Foundation of China","award":["JYHX2025007"],"award-info":[{"award-number":["JYHX2025007"]}]},{"name":"National Natural Science Foundation of China","award":["JYHX2025014"],"award-info":[{"award-number":["JYHX2025014"]}]},{"name":"Shanghai Plastic Surgery Research Center of Shanghai Priority Research Center","award":["82272288"],"award-info":[{"award-number":["82272288"]}]},{"name":"Shanghai Plastic Surgery Research Center of Shanghai Priority Research Center","award":["82472577"],"award-info":[{"award-number":["82472577"]}]},{"name":"Shanghai Plastic Surgery Research Center of Shanghai Priority Research Center","award":["2023ZZ02023"],"award-info":[{"award-number":["2023ZZ02023"]}]},{"name":"Shanghai Plastic Surgery Research Center of Shanghai Priority Research Center","award":["JYHX2025007"],"award-info":[{"award-number":["JYHX2025007"]}]},{"name":"Shanghai Plastic Surgery Research Center of Shanghai Priority Research Center","award":["JYHX2025014"],"award-info":[{"award-number":["JYHX2025014"]}]},{"name":"Industry-commissioned research project from Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine","award":["82272288"],"award-info":[{"award-number":["82272288"]}]},{"name":"Industry-commissioned research project from Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine","award":["82472577"],"award-info":[{"award-number":["82472577"]}]},{"name":"Industry-commissioned research project from Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine","award":["2023ZZ02023"],"award-info":[{"award-number":["2023ZZ02023"]}]},{"name":"Industry-commissioned research project from Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine","award":["JYHX2025007"],"award-info":[{"award-number":["JYHX2025007"]}]},{"name":"Industry-commissioned research project from Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine","award":["JYHX2025014"],"award-info":[{"award-number":["JYHX2025014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: This study assesses the efficacy of tracheotomy-primed sclerotherapy in craniofacial venous malformations (VMs), establishes evidence-based airway intervention criteria, and develops site-specific safety protocols to optimize treatment timing and safety in cases with upper airway compromise. Methods: We retrospectively collected the clinical data of 35 patients treated by our center between January 2008 and November 2024, who were diagnosed with cervicofacial VMs involving the upper respiratory tract. All patients underwent direct tracheotomy or tracheotomy after sclerotherapy for lesions located in the anterior cervical area. Sclerotherapy was performed under fluoroscopy or laryngoscopy after tracheotomy. Results: 35 patients underwent 225 sclerotherapy sessions. Nineteen patients underwent tracheotomy directly, and sixteen patients received sclerotherapy at the anterior cervical area before tracheotomy. All patients presented improvement according to magnetic resonance imaging (MRI) findings, and 94.29% (33\/35) of patients reported improvement in clinical presentations. All patients experienced improvement in quality of life (QoL). No major complications occurred. Decannulation was successfully performed in all 35 patients after finishing sclerotherapy. Conclusions: Tracheotomy followed by sclerotherapy is safe and effective for VMs involving the upper respiratory tract. This is necessary for patients with lesions involving the laryngopharyngeal region, tongue base, and bilateral pharyngeal walls. In high-risk prophylactic tracheostomy candidates, anterior cervical sclerotherapy\u2013tracheostomy\u2013sclerotherapy (ACSTS) is an effective strategy for managing airway obstruction.<\/jats:p>","DOI":"10.3390\/jcm14176154","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T13:01:13Z","timestamp":1756818073000},"page":"6154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Airway First: A Retrospective Study of Tracheotomy-Primed Sclerotherapy for High-Risk Cervicofacial Venous Malformations"],"prefix":"10.3390","volume":"14","author":[{"given":"Xuan","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunbo","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxi","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"},{"name":"Department of Laser and Aesthetic Medicine, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1601-0825.2010.01661.x","article-title":"Diagnosis and management of hemangiomas and vascular malformations of the head and neck","volume":"16","author":"Buckmiller","year":"2010","journal-title":"Oral Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0011-3840(00)80013-1","article-title":"Vascular anomalies","volume":"37","author":"Mulliken","year":"2000","journal-title":"Curr. Probl. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1055\/s-0032-1329937","article-title":"Vascular neoplasms and malformations involving the airway","volume":"28","author":"Harris","year":"2012","journal-title":"Facial Plast. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.bjps.2012.09.002","article-title":"Sclerotherapy for vascular malformations: Complications and a review of techniques to avoid them","volume":"66","author":"Odeyinde","year":"2013","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e27008","DOI":"10.1002\/pbc.27008","article-title":"Short-term side effects and patient-reported outcomes of bleomycin sclerotherapy in vascular malformations","volume":"65","author":"Mack","year":"2018","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/j.jvs.2008.01.010","article-title":"Sclerotherapy after embolization of draining vein: A safe treatment method for venous malformations","volume":"47","author":"Jin","year":"2008","journal-title":"J. Vasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/j.jvsv.2019.11.022","article-title":"Interim results of bleomycin-polidocanol foam sclerotherapy as a highly efficient technique for venous malformations","volume":"8","author":"Yang","year":"2020","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.jvsv.2022.08.004","article-title":"A systematic review and network meta-analysis of the effectiveness of sclerotherapy for venous malformation","volume":"11","author":"Cao","year":"2023","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1111\/jop.13287","article-title":"Intralesional therapies for vascular malformations of the head and neck","volume":"51","author":"Wadhwa","year":"2022","journal-title":"J. Oral. Pathol. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/jop.13324","article-title":"Medical management of vascular anomalies of the head and neck","volume":"51","year":"2022","journal-title":"J. Oral. Pathol. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1001\/jamaoto.2020.4353","article-title":"Contemporary Management of Vascular Anomalies of the Head and Neck-Part 1: Vascular Malformations: A Review","volume":"147","author":"Gallant","year":"2021","journal-title":"JAMA Otolaryngol. Head. Neck Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1007\/s002470050718","article-title":"Imaging and therapeutic approach of hemangiomas and vascular malformations in the pediatric age group","volume":"29","author":"Dubois","year":"1999","journal-title":"Pediatr. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/j.1460-9592.2009.02972.x","article-title":"Airway rescue with an esophageal airway in a child with a huge venous malformation in oral and maxillofacial region\u2014A case report","volume":"19","author":"Sun","year":"2009","journal-title":"Pediatr. Anesth."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"74","DOI":"10.3315\/jdcr.2013.1145","article-title":"Life-threatening pharyngeal edema after sclerotherapy of oral venous malformations in a patient with blue rubber bleb nevus syndrome","volume":"7","author":"Lindsey","year":"2013","journal-title":"J. Dermatol. Case Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1111\/j.1460-9592.2006.01926.x","article-title":"Airway rescue with laryngeal mask airway during sclerotherapy of a large arteriovenous malformation in the oral and maxillofacial region","volume":"16","author":"Batra","year":"2006","journal-title":"Pediatr. Anesth."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1177\/014556130808700715","article-title":"An unusual case of adult airway obstruction from a lymphovenous malformation","volume":"87","author":"Harsha","year":"2008","journal-title":"Ear Nose Throat J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1002\/hed.24588","article-title":"Direct intralesional ethanol sclerotherapy of extensive venous malformations with oropharyngeal involvement after a temporary tracheotomy in the head and neck: Initial results","volume":"39","author":"Wang","year":"2017","journal-title":"Head Neck"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1002\/ohn.843","article-title":"Tracheostomy Incidence and Complications: A National Database Analysis","volume":"171","author":"Strober","year":"2024","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1067\/mhn.2000.105714","article-title":"Tracheotomy complications: A retrospective study of 1130 cases","volume":"123","author":"Goldenberg","year":"2000","journal-title":"Otolaryngol. Head Neck Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/6154\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:36:22Z","timestamp":1760034982000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/6154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,30]]},"references-count":19,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14176154"],"URL":"https:\/\/doi.org\/10.3390\/jcm14176154","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,30]]}}}