Treating head and neck venous malformations with cold helium plasma electrosurgical device: A 17 patients case series

Venous malformations (VMs) are some of the most common vascular malformations. Their treatment varies from laser to sclerotherapy and surgery. For many years, radiofrequency and argon plasma devices have been used on soft tissues VMs. However, their use has been limited because of high thermal impact of nearby structures. The here described cold-helium plasma electrosurgical device carries intrinsic bio-technical advantages, as the helium plasma beam manages to move towards tissues with less impedance, such as VM vessels. The primary objective of this study was to assess if J-Plasma® could be effective on treating the superficial portion of VMs, in a single or multimodal approach. From January 2022 to January 2024, 17 patients affected by head and neck VM involving mucosa or skin were treated using J-Plasma®, in addition to sclerotherapy. More than 1 session was needed in all but 1 patient. All patients showed a progressive shrinkage of the venous chambers and thickening of the surface, while no major intraoperative and perioperative complications, such as necrosis or severe bleeding were observed. Minor complications like oedema or exfoliation were mild. All 17 patients had a complete healing of the mucosal surface one week after treatment. The grade of effectiveness and the stability of the results correlated with the complexity of the VMs. This research may serve as groundwork for future studies that may aim to explore the use of this device on other vascular malformations. Level of evidence: Case series: level 4.