HomePhilippine Journal of Otolaryngology Head and Neck Surgeryvol. 26 no. 2 (2011)

Arterio-Venous Malformation in the External Ear in Pregnancy

Normita S. Pangan



Arterio-Venous Malformations (AVMs) are congenital vascular defects1 and are most commonly located in the head and neck area (81%).2 The majority of these were localized over the cheek (31%) , ear(16%), nose (10%), forehead(10%), upper lip (7%), mandible (5%), neck (5%), and scalp and maxilla (4%).2 There is equal predominance in males and females and no racial predilection.2 In general, there is “sparse literature about AVM in the external ear,”3 let alone its occurrence in a pregnant patient.
Arterio-venous malformations are composed of a central nidus with anomalous arteriovenous shunts and a network of surrounding collateral vessels.4 The short circuit or shunting between the high pressure arterial and low pressure venous system accounts for much of the clinical presentation, anatomical changes and progression of the lesions. They are usually present at birth but commonly manifest in childhood or adolescence with gradual onset and progression and rarely can be associated with an enlarged heart and high output cardiac failure.3,5 The size of AVMs may increase rapidly secondary to infection, trauma, ligation or attempted excision and hormonal influences like pregnancy and puberty.3 We present the case of an AVM occurring in the external ear of a pregnant patient.