Vascular Surgery in the Head and Neck: Current Concepts

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or combined malformations.Venous malformations are categorized into isolated, multifocal, and syndromic forms.Lymphatic malformations are classified into isolated lesions, complex lymphatic anomalies, and lymphedema disorders.Capillary malformations are now grouped based on cutaneous pattern, genetic associations, and syndromic features.Combined vascular malformations are categorized into isolated and syndromic forms.Developmental anomalies of named vessels are simplified by naming the affected major vessel directly.3 This classification is essential as it directly influences treatment planning, prognosis, and selection of surgical or endovascular intervention. CliniCal indiCations f o r VasCular surgeryVascular surgery is indicated for a variety of conditions in the head and neck region.These involve conditions related to major blood vessels and surrounding soft tissues. TumorsOne of the common indications includes both benign and malignant tumors that involve or compress vascular structures.Highly vascular tumors such as paragangliomas, hemangiomas, angiosarcomas, introduCtion Vascular surgery plays a central role in the management of vascular diseases of the head and neck region, significantly improving patient outcomes worldwide.This surgical specialty includes a broad range of procedures used to treat conditions affecting the head and neck, including benign and malignant tumors, arteriovenous malformations, traumatic injuries, aneurysms, and atherosclerotic disease.Surgical intervention is challenging in this anatomical region because there is a close relationship between major blood vessels, cranial nerves, the upper airway, and other essential soft-tissue structures in this region.1 As the head and neck region is an anatomically intricate and functionally important region, surgery of this region is aimed at restoring complex functions such as speech, swallowing, and breathing.It is also important in keeping facial form and patient identity intact as much as possible.Therefore, careful preoperative planning, technical expertise, and a multidisciplinary approach including vascular surgeons, head and neck surgeons, radiologists, anesthesiologists, and reconstructive specialists are necessary.2 ClassifiCation o f VasCular anomaliesThe updated International Society for the Study of Vascular Anomalies (ISSVA) classification has simplified terminology and improved diagnostic organization.Vascular anomalies are now widely classified into vascular tumors, vascular malformations, and potentially unique vascular anomalies (PUVA).Among these, vascular tumors have been reorganized into three groups, including benign, borderline, and malignant tumors.Vascular malformations are classified into fast-flow malformations, slowflow malformations, and developmental anomalies of named vessels.Fast-flow malformations are subdivided into isolated, multifocal, and syndromic types.Slow-flow malformations are categorized by vessel type into capillary, lymphatic, venous,

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