Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series

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This study aimed to analyze literature on head and neck AVM recurrence post-treatment and identify the most effective strategy with a lower recurrence rate. Objectives To analyse existing literature on the recurrence of head and neck AVMs following treatment. Our goal was to identify the most effective treatment option with a lower recurrence rate. Methods We conducted a thorough literature search using PubMed, ScienceDirect, and Scopus, from year 2000 to the present. Our analysis focused on key endpoints, specifically the recurrence rates of head and neck AVMs following various treatment approaches. Results Out of the initial pool of 108 screened articles, a total of 83 patients were deemed suitable for inclusion in the literature review. The reviewed articles demonstrated that appropriate diagnostic tests were documented in 95% of the included studies. Among the patients, 37.3% had previously undergone interventions and were currently dealing with regrowth masses. Notably, 55.4% of patients underwent a combined approach involving both endovascular and surgical methods, while 25.3% opted for a surgical-only approach, and only 19.3% pursued an endovascular-only approach. The studies showed a promising curing rate of AVMs, with a success rate of 94%, albeit with a complication rate of 32.5%. The average follow-up duration for all patients was 26 months, with a standard deviation of 20.5 months. Out of the 83 patients, 5 experienced recurrence, with single-modality approach. Interestingly, no patients who received a multi-modality of treatments experienced recurrence or regrowth of the AVM mass within the follow up period. Conclusion The multi-modality approach outperformed single-modality treatments in preventing AVM recurrence. These findings highlight the importance of a comprehensive and multidisciplinary approach in the management of these complex vascular anomalies. PROSPERO: CRD42023490871 registered on 17/12/2023 " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/13-697/v2", "name": "Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous..." } } ] } Home Browse Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Putra AW, Indrasari SR, Herdini C and Yudistira D. Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.12688/f1000research.147233.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Systematic Review Revised Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] Agustian Winarno Putra https://orcid.org/0009-0009-0135-1260 1,2 , Sagung Rai Indrasari https://orcid.org/0000-0002-4281-8105 1,2 , Camelia Herdini https://orcid.org/0009-0009-8273-5679 1,2 , Danu Yudistira https://orcid.org/0000-0002-9072-1113 1,2 Agustian Winarno Putra https://orcid.org/0009-0009-0135-1260 1,2 , Sagung Rai Indrasari https://orcid.org/0000-0002-4281-8105 1,2 , Camelia Herdini https://orcid.org/0009-0009-8273-5679 1,2 , Danu Yudistira https://orcid.org/0000-0002-9072-1113 1,2 PUBLISHED 24 Dec 2024 Author details Author details 1 Dr. Sardjito General Hospital, Sleman, Yogyakarta, 55281, Indonesia 2 Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, Yogyakarta, 55281, Indonesia Agustian Winarno Putra Roles: Conceptualization, Investigation, Methodology, Project Administration, Software, Writing – Original Draft Preparation, Writing – Review & Editing Sagung Rai Indrasari Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Resources, Supervision, Validation, Writing – Review & Editing Camelia Herdini Roles: Methodology, Supervision, Validation, Writing – Review & Editing Danu Yudistira Roles: Methodology, Software, Supervision, Validation, Visualization, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Arteriovenous malformations (AVMs) in the head and neck pose a challenge in their management due to their local aggressiveness and high recurrence risk. This study aimed to analyze literature on head and neck AVM recurrence post-treatment and identify the most effective strategy with a lower recurrence rate. Objectives To analyse existing literature on the recurrence of head and neck AVMs following treatment. Our goal was to identify the most effective treatment option with a lower recurrence rate. Methods We conducted a thorough literature search using PubMed, ScienceDirect, and Scopus, from year 2000 to the present. Our analysis focused on key endpoints, specifically the recurrence rates of head and neck AVMs following various treatment approaches. Results Out of the initial pool of 108 screened articles, a total of 83 patients were deemed suitable for inclusion in the literature review. The reviewed articles demonstrated that appropriate diagnostic tests were documented in 95% of the included studies. Among the patients, 37.3% had previously undergone interventions and were currently dealing with regrowth masses. Notably, 55.4% of patients underwent a combined approach involving both endovascular and surgical methods, while 25.3% opted for a surgical-only approach, and only 19.3% pursued an endovascular-only approach. The studies showed a promising curing rate of AVMs, with a success rate of 94%, albeit with a complication rate of 32.5%. The average follow-up duration for all patients was 26 months, with a standard deviation of 20.5 months. Out of the 83 patients, 5 experienced recurrence, with single-modality approach. Interestingly, no patients who received a multi-modality of treatments experienced recurrence or regrowth of the AVM mass within the follow up period. Conclusion The multi-modality approach outperformed single-modality treatments in preventing AVM recurrence. These findings highlight the importance of a comprehensive and multidisciplinary approach in the management of these complex vascular anomalies. PROSPERO: CRD42023490871 registered on 17/12/2023 READ ALL READ LESS Keywords Arteriovenous Malformations, Head and neck, Surgery, Endovascular, Embolization, Recurrence Corresponding Author(s) Sagung Rai Indrasari ( [email protected] ) Close Corresponding author: Sagung Rai Indrasari Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Putra AW et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Putra AW, Indrasari SR, Herdini C and Yudistira D. Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.12688/f1000research.147233.2 ) First published: 27 Jun 2024, 13 :697 ( https://doi.org/10.12688/f1000research.147233.1 ) Latest published: 24 Dec 2024, 13 :697 ( https://doi.org/10.12688/f1000research.147233.2 ) Revised Amendments from Version 1 During the revision process, we re-evaluated all the data and found an error in our initial assessment. Specifically, we mistakenly stated that 33 studies were excluded, resulting in 19 studies being included in the final analysis. In fact, 32 studies were excluded, and 20 studies were included in the final analysis. There are no changes to the actual number of final patients eligible for analysis. We apologize for the error in which we incorrectly stated that the patient reported by Ferres et al. (2015) underwent both endovascular and surgical approaches. In fact, the treatment was solely via the endovascular approach using a sclerosing agent. Additionally, we rearranged the order of patients in the table to match the original publication, making it easier to cross-check the data. We also incorporated literature regarding the role of reconstruction with well-vascularized tissue following surgical excision. One publication suggests that free flaps are superior to pedicled flaps or skin grafts, and another study supports the underlying theory. While this topic has piqued our interest, we believe it warrants a more detailed review and in-depth discussion in a separate publication. During the revision process, we re-evaluated all the data and found an error in our initial assessment. Specifically, we mistakenly stated that 33 studies were excluded, resulting in 19 studies being included in the final analysis. In fact, 32 studies were excluded, and 20 studies were included in the final analysis. There are no changes to the actual number of final patients eligible for analysis. We apologize for the error in which we incorrectly stated that the patient reported by Ferres et al. (2015) underwent both endovascular and surgical approaches. In fact, the treatment was solely via the endovascular approach using a sclerosing agent. Additionally, we rearranged the order of patients in the table to match the original publication, making it easier to cross-check the data. We also incorporated literature regarding the role of reconstruction with well-vascularized tissue following surgical excision. One publication suggests that free flaps are superior to pedicled flaps or skin grafts, and another study supports the underlying theory. While this topic has piqued our interest, we believe it warrants a more detailed review and in-depth discussion in a separate publication. See the authors' detailed response to the review by Remco de Bree See the authors' detailed response to the review by Mustafa Ismail READ REVIEWER RESPONSES Introduction Arteriovenous malformations (AVMs) make up a mere 1.5% of all vascular anomalies, and they are frequently found in the head and neck region (47.4%) as well as the extremities (28.5%). There are two main types of AVMs: focal and diffuse. Focal AVMs appear as soft tissue mass and are generally diagnosed during infancy or childhood. They possess a single arterial feeder, distinct borders, and a nidus. These types of AVMs typically respond well to appropriate treatment. In contrast, diffuse AVMs extend across and tend to disrupt tissue boundaries. They are more often identified in older children and adults. Diffuse lesions are more challenging to treat due to their multiple feeding vessels, necessitating close monitoring and repeated interventions. 1 , 2 Although AVMs are not malignant, they can be locally aggressive and destructive, leading to complications such as severe disfigurement, ulceration, massive haemorrhage, pain and, in the worst cases, heart failure. These anomalies have tendencies to expand, occasionally undergoing sudden increases in growth, influenced by factors like trauma, hormonal changes, or iatrogenic causes The diagnosis was established based on medical history, physical examination, and usually confirmed by MR-angiography or CT-angiography. 3 , 4 The treatment of AVMs is still controversial; there are no staging criteria or standardized guidelines, and treatment options vary from a conservative approach to more aggressive strategies. In the past, surgical excision was the predominant approach compared to endovascular embolization therapy for arteriovenous malformations (AVMs). However, the current trend is to limit surgical excision to small, localized AVMs due to the unacceptable risk of significant bleeding associated with the procedure. Endovascular embolization treatment often require multiple sessions for comprehensive closure of the AVM. When endovascular treatment is not followed by a surgical phase, potentially leading to recurrences after the natural degradation of embolic materials. A multidisciplinary approach with a combined treatment based on endovascular embolization and surgical excision is a good compromise and is rated a good choice by several studies. 5 – 7 In this context, we present the outcomes of various modality treatment for management AVMs in the head and neck. The main objective of this research was to perform a comprehensive analysis of existing literature concerning the recurrence of head and neck AVMs following treatment. Our goal was to identify the most effective treatment option with a lower recurrence rate Methods We conducted an extensive and systematic literature review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our study was registered in PROSPERO: CRD42023490871 on December 17, 2023. We identified suitable studies using the online search engines PubMed, Scopus, and ScienceDirect. The keywords for the search are “Arteriovenous Malformations”, “AVMs”, “Head and Neck”, “Endovascular”, “Surgical”. All clinical studies targeting treatment, outcome, complication and recurrence of AVMs of the head and neck were included in the primary review. Retrospective and prospective English studies, as well as case reports published between January 2000 and October 2023 were included. There were no restrictions as to the country of origin, clinical setting or size of the institution in which the treatments were performed. We did not set a minimum sample size of the studies, as any clinical findings or experience in treatment might be of value to clinicians or future studies. We excluded reports that did not specified the therapy used and follow up period. 8 We also excluded patients that were loss to follow up and reported still undergoing treatment. First and second author reviewed the title, abstracts and full-text and discussed which literatures to include and exclude in the review. If authors encountered confusion, a third and fourth author were consulted to establish a consensus. The data that this study collected including age, gender, location of AVMs, imaging modality, history of previous intervention, treatment modality, follow up period, recurrences and complications. Our analysis focused on key endpoints, specifically the recurrence rates of head and neck arteriovenous malformations following various treatment approaches. As interventional therapy of AVMs of the head and neck details on gender, age, of the treated patients were inconsistently reported, they did not undergo analysis. Results Our search generated a total of 162 citations, and identified a total of 108 potentially relevant articles. Of these articles, a total of 51 articles merited full text review. Based on the above-listed inclusion and exclusion criteria mentioned in our PRISMA figure ( Figure 1 ), a total of 20 articles were included in the analysis. From the 20 articles, 83 patients ( Table 1 ) were deemed suitable for inclusion in the literature review. Figure 1. PRISMA flow diagram of the study. Table 1. Baseline Characteristics. Study Reference Age (Years), Sex Location of AVMs Imaging Modality Treatment Modality Follow up (months) Recurrance Complication Almesberger et al., 2016 2 40, F Cheek and nose Doppler ultrasound, angiography, MRI Embolization and surgery 72 No Wound dehiscence 39, F Nose Doppler ultrasound, angiography, MRI Embolization and surgery 72 No Wound dehiscence Aslan et al., 2008 4 33, F Right retro auricula MRI, CT, angiography Embolization and surgery 36 No Byatnal et al., 2014 6 19, M Temporal MRA, MRI, angiography Surgical 6 No Chelilah et al., 2018 7 32, M Tongue - Endovascular 6 No Oral erosion 44, M Right inferior ear and neck MRI Endovascular 18 No 9, F Right clavicle MRI Endovascular 20 No Localized erosion, oral erosion 33, F Left upper lip and cheek MRI Endovascular 8 No Oral erosion 16, M Left cheek, ear and neck MRI Endovascular 40 Yes Pulmonary embolism, oral erosion 13, M Forehead MRI Embolization and surgery 15 No Pruritus Chimona et al., 2005 14 52, F Left side of the floor of the mouth MRI, doppler ultrasound, arteriography Embolization and surgery 24 No Cuong et al., 2023 15 46, M Left ear Angiography, DSA Embolization and surgery 7 No Dry skin Ferres et al., 2015 16 9, F Mandibular left first molar CT, MRA Embolization 96 No Gennaro et al., 2023 5 48, M Left cheek CT, MRI, Angiography Embolization and surgery 12 No 57, F Left nose wing CT, MRI, Angiography Embolization and surgery 12 No 27, F Right cheek CT, MRI, Angiography Embolization and surgery 12 No 63, M Inferior lip CT, MRI, Angiography Embolization and surgery 12 No 28, F Frontal CT, MRI, Angiography Embolization and surgery 12 No 39, M Right cheek CT, MRI, Angiography Embolization and surgery 12 No Cutaneous dyschromia 37, F Superior lip CT, MRI, Angiography Embolization and surgery 12 No Lip asymmetry 40, F Right cheek CT, MRI, Angiography Embolization and surgery 12 No 20, M Inferior lip CT, MRI, Angiography Embolization and surgery 12 No 24, M Frontal CT, MRI, Angiography Embolization and surgery 12 No Wound dehiscence 34, M Left auricular cervical extending CT, MRI, Angiography Embolization and surgery 12 No Wound dehiscence 9, M Superior lip CT, MRI, Angiography Embolization and surgery 12 No 22, M Left auricular cervical extending CT, MRI, Angiography Embolization and surgery 12 No 35, M Left superior eyelid CT, MRI, Angiography Embolization and surgery 12 No Han et al., 2015 17 13, M Lip Angiography Embolization and surgery 6 No Hosny et al., 2020 18 32, F Forehead CTA, doppler ultrasound Surgical 12 Yes 46, M Below right ear CTA Surgical 12 No Koshima et al., 2003 19 32, F Left cheek Angiography Embolization and surgery 48 No 64, M Left cervical and temporal region Angiography Embolization and surgery 84 No Temporary facial palsy Lee et al., 2013 20 25, F Cheek MRI, angiography, CT Surgical 24 Yes Palsy right side of treatment Liljie et al., 2022 21 47, M Nose MRI, MRA, angiography Embolization and surgery 72 No 12, F Mandible, floor of the mouth MRI, MRA, angiography Embolization and surgery 52 No 32, F Mandible, floor of the mouth MRI, MRA, angiography Embolization and surgery 13 No 30, F Mandible, floor of the mouth MRI, MRA, angiography Embolization and surgery 38 No 18, F Mandible, floor of the mouth MRI, MRA, angiography Embolization and surgery 15 No Martines et al., 2009 22 32, F Base of tongue CT, Angiography Endovascular 6 No Haemoptysis Pekkola et al., 2013 8 42, F Tongue MRI, MRA Endovascular 11 No 20, F Nose, ala nasion, periorbita MRI, MRA Endovascular 24 Yes 30,M Mid and lower face, lower lip MRI, MRA Endovascular 30 No 12, M Upper lip MRI, MRA Endovascular 11 No 15, F Lower lip MRI, MRA Endovascular 5 No 17, F Cheek, submandibular area MRI, MRA Endovascular 15 No 23, F Auricle MRI, MRA Endovascular 12 No 30, M Midface, upper lip MRI, MRA Endovascular 12 No 33,F Auricle, scalp MRI, MRA Endovascular 6 No Pompa., 2011 10 21, F Front MRI, angiography, CT Embolization and surgery 28 No 10, F Front MRI, angiography Embolization and surgery 24 No 36, M Lips MRI, angiography, CT Embolization and surgery 24 No 41, F Mandibula MRI, angiography, CT Embolization and surgery 6 No 15, M Cheek MRI, angiography Embolization and surgery 36 No 23, M Cheek MRI, angiography Embolization and surgery 36 No 18, M Lips Angiography Embolization and surgery 60 No 21, M Lips Angiography Embolization and surgery 60 No 8, F Cheek MRI, angiography Embolization and surgery 48 No 35, M Mandible MRI, angiography, CT Embolization and surgery 45 No 42, M Neck MRI, angiography, CT Embolization and surgery 43 No 29, F Lips - Surgical 38 No 40, M Lips - Surgical 38 No 18, M lips MRI, angiography, CT Surgical 29 No 28, M Nasal dorsum CT Surgical 28 No 14, F Lips - Surgical 19 No 9, M Front MRI, angiography, CT Surgical 15 No 6, M Cheek MRI, angiography Surgical 12 No 36, M Front MRI Surgical 56 Yes Prasad et al., 2004 23 26, F Right side of nose and forehead CT, Angiography, doppler ultrasound Surgical 72 No Rajput et al., 2022 3 18, F Buccinator MRI, angiography Embolization and surgery 3 No wound dehiscence Richter et al., 2010 24 15 Right tongue, floor of mouth, Retro molar triangle, superior pharynx, tonsil MRI, angiography Embolization and surgery 11 No unable to inflate her cheeks 11 Base of tongue, floor of mouth, Neck MRI, angiography Embolization and surgery 11 No 21 Right tongue, face, mandible, floor of mouth, lower lip MRI, angiography Embolization and surgery 11 No 24 Left tongue, base of tongue, floor of mouth, neck MRI Embolization and surgery 11 No 8 months Left tongue tip MRI, angiography Surgical 11 No 6 months Right tongue base MRI, angiography Surgical 11 No 6 months Base of tongue MRI, angiography Surgical 11 No 11 Right tongue mid MRI, angiography Surgical 11 No 13 Right tongue base MRI, angiography Surgical 11 No 8 Left tongue base MRI, angiography Surgical 11 No 41 Right tongue base MRI, angiography Surgical 11 No Ros de San Pedro et al., 2018 9 46, M Temporal muscle CT, Angiography Embolization and surgery 12 No 37, M Temporal muscle CT, MRI, Angiography Surgical 48 No The reviewed articles demonstrated that appropriate diagnostic tests were documented among the 83 patients, a total of 79 individuals, accounting for 95%, utilized angiography, CT, or MRI, either individually or in combination, for diagnosing AVMs ( Table 2 ). Among the clinicians, the most preferred modalities were MRI, with 68 cases (82%), and angiography, with 62 cases (75%). Table 2. Percentage of Imaging Modality Used (N=83). Imaging Modality Cases (%) Conventional Angiography 62 (75.0) Computed Tomography 33 (40.0) Magnetic Resonance Imaging 68 (82.0) Digital Subtraction Angiography 3 (4.0) Doppler ultrasound 5 (6.0) None reported 4 (5.0) 31 individuals among 83 patients, or 37.3%, had previously undergone treatment. This indicates a recurrence rate of 37.3% among the reported cases of AVMs in the head and neck region. It’s important to note that the treatment methods used were evenly distributed among the endovascular approach, surgical approach, and a combination of endovascular and surgical approaches. with 22.6%, 38.7%, 36.7% subsequently ( Table 3 ). Table 3. Percentage of patient with previous intervention (N=83). Treatment Modality Cases (%) Endovascular approach 7 (22.6) Surgical approach 12 (38.7) Combination Endovascular and Surgical approach 12 (36.7) Out of the 83 reported patients, the combination of endovascular and surgical approach emerged as the most favored method. We identify notably 46 or 55.4% of patients underwent a combined approach involving both endovascular and surgical methods, while 21 patients (25.3%) opted for a surgical-only approach, and only 16 patients (19.3%) pursued an endovascular-only approach. With an average follow-up period of 26 months, combined approach exhibited a remarkable outcome with a 0% recurrence rate. In contrast, the endovascular approach had a 12.5% recurrence rate, and the surgical approach showed a 14.2% recurrence rate, making the combination approach the most successful in preventing AVM recurrence ( Table 4 ). Table 4. Percentage of recurrences (N=83). Treatment Modality Cases (%) Recurrences (%) Endovascular approach 16 (19.3) 2 (12.5) Surgical approach 21 (25.3) 3 (14.2) Combination Endovascular and Surgical approach 46 (55.4) 0 (0.0) Out of the 83 cases, 27 complications were reported, representing a complication rate of 32.5%. The surgical approach alone demonstrated the lowest complication rate, with only 2 cases (9.5%). In contrast, the endovascular approach and the combination of endovascular and surgical approach had complication rates of 37.5% and 41.3%, respectively ( Table 5 ). The most prevalent complication was wound dehiscence, occurring in 11 out of the 27 cases with complications, making up 40.7% of the reported complication cases ( Table 6 ). Table 5. Percentage of complications (N=83). Treatment Modality Cases (%) Complication (%) Endovascular approach 16 (19.3) 6 (37.5) Surgical approach 21 (25.3) 2 (9.5) Combination Endovascular and Surgical approach 46 (55.4) 19 (41.3) Table 6. Percentage of complication (N=27). Complication Cases (%) Pruritus 1 (3.7%) Dry skin 1 (3.7%) Discoloration 1 (3.7%) Erosion 5 (18.5%) Haemoptysis 1 (3.7%) Wound dehiscence 11 (40.7%) Asymmetry 1 (3.7%) Palsy 3 (11.1%) Pulmonary Embolism 1 (3.7%) Paresthesia 4 (14.8%) Discussion A clinical diagnosis of arteriovenous malformation is diagnosed through the patient’s medical history, physical examination and supportive examination are crucial especially MRI and angiography. MRI currently serves as the definitive method for assessing the extent of involvement within tissue planes and illustrating flow characteristics. Angiography plays a vital role in revealing the feeding vessels, offering insights into anastomoses with other extracranial or intracranial vessels, and providing details about the venous drainage pattern for ‘super selective’ embolization. During embolization, the focus should be on the nidus or epicenter of the arteriovenous malformation rather than the proximal feeding vessels. 4 Complete removal of AVMs is imperative to prevent recurrence. To achieve this, a customized approach must be devised for each patient, taking into consideration the specific boundaries of the lesion. The excision process may involve the removal of three different structures: fascia, muscle, and bone. In cases where preoperative embolization has not been performed, extended resection into apparently normal tissue is advised to ensure the thorough elimination of the AVMs. 9 The management of AVMs remains the most debated aspect in the medical literature, with no universally accepted approach. Previously, the treatment methods were evenly distributed among the endovascular approach, surgical approach, and a combination of endovascular and surgical approaches. 10 Currently, the preferred treatment involves selectively embolizing vessels combined with surgical resection and subsequent reconstruction of soft tissues. The primary goal of preoperative embolization is to minimize blood loss and enhance the surgical procedure, emphasizing that it should not be seen as a method for reducing the extent of resection. It is crucial not to postpone surgical resection beyond 48 hours after embolization, as the inflammation that ensues makes the hemodynamic benefits ineffective and renders the surgery more challenging. 10 Recurrence of AVMs has been reported in as much as 80% of cases following embolization or resection. In cases where the nidus is incompletely removed or embolized, there is a heightened risk of aggressive growth in the remaining lesion, leading to a potential progression risk as high as 50% within the initial five years. 1 In recent literature findings, the recurrence rate of AVMs that managed with combined approach of both endoscopic and surgical approach give a remarkable outcome with a 0% recurrence rate. This result most likely because the surgeons are able to obtain a clear surgical vision field and completely excise the AVMs mass margin, as a result of the pre-embolization of the AVMs mass. The presence of a clear margin and minimal bleeding likely contributes to this successful outcome. Recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF). These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formation. 11 The use of well-vascularized tissue in reconstruction is essential for avoiding post-excisional ischemia, which can trigger collateralization, parasitization, and neovessel recruitment from the surrounding mesenchyme, contributing to AVM recurrence. Evidence indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period. 12 Currently, in our literature search, the management of AVMs mass shows a lower recurrence rate than previously believed. However, the average follow-up period was 26 months. In some literature recurrences have been observed a decade after treatment, highlighting the essential need for extended post-treatment follow-up to ensure timely detection. It’s crucial to acknowledge that the interpretation of the term “cure” varies in the literature, and reported instances of “cure” may be influenced by limited follow-up periods. Some cases defined “cure” as an asymptomatic state following embolization rather than a complete absence of the condition. 1 , 13 Study strength and limitations To our understanding, several studies have documented cases and case series involving patients with AVMs in the head and neck region, who were treated using diverse approaches such as endovascular, surgical, or a combination of both. Nevertheless, as of now, no systematic review has been conducted to determine the most effective treatment approach, particularly in relation to the recurrence of the mass. The limitations of this study is the lack of randomization due to the rarity of the case we included all studies that met the inclusion criteria regardless of the size of the lesion, race, gender, age and location. Subsequently, even though the average follow-up period was 26 months, the follow up period of the studies varies greatly ranging from 6 month to 8 years. The lack of literature addressing the recommended follow-up timeframe for AVMs mass contributes to the uncertainty. Some studies even report occurrences of AVMs mass recurrence a decade post-treatment. 13 Conclusion The multi-modality of endovascular and surgical approaches has a lower recurrence rate of AVM masses compared to a single-modality treatment. These findings highlight the importance of a comprehensive and multidisciplinary approach in contributing to the successful surgical outcomes of these complex vascular anomalies. Ethics and consent Ethical approval and written informed consent were not required. Data availability statement Underlying data All data underlying the results are available as part of the article (included under extended data) and no additional source data are required. Extended data Supplementary data : Figshare: Tabel 1. Baseline Characteristic, https://doi.org/10.6084/m9.figshare.25931002.v3 . 25 Reporting guidelines Figshare: PRISMA Checklist https://doi.org/10.6084/m9.figshare.24995798.v2 . 26 Figshare: PRISMA Flowchart https://doi.org/10.6084/m9.figshare.25783014.v2 . 27 Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver (CC0 1.0 Public domain dedication). Acknowledgements The authors express their gratitude to the Department of Otorhinolaryngology, Faculty of Medicine, Public Health, and Nursing at Gadjah Mada University for providing updated insights into systematic review. References 1. Fernández-Alvarez V, Suárez C, De Bree R, et al. : Management of extracranial arteriovenous malformations of the head and neck. Auris Nasus Larynx. 2020 Apr; 47 (2): 181–190. 2. Almesberger D, Manna F, Guarneri GF, et al. : Arterio-Venous Malformations of the Nose: Combined Approach for a Successful Strategy. J Craniofac Surg. 2016 Sep; 27 (6): 1524–1526. PubMed Abstract | Publisher Full Text 3. Rajput D, Vasudevan C, Sant C, et al. : AV Malformation Within Buccinator Muscle-A Unique Finding. Indian J Otolaryngol Head Neck Surg. 2022 Dec; 74 (Suppl 3): 6241–6245. PubMed Abstract | Publisher Full Text | Free Full Text 4. Aslan S, Yavuz H, Cagici AC, et al. : Embolisation of an extensive arteriovenous malformation of the temporal region as an alternate treatment: case report. J Laryngol Otol. 2008 Jul; 122 (7): 737–740. PubMed Abstract | Publisher Full Text 5. Gennaro P, Cioni S, Bracco S, et al. : A Single-Center Retrospective Analysis of 14 Head and Neck AVMs Cases Treated with a Single-Day Combined Endovascular and Surgical Approach. J Pers Med. 2023 Apr 28; 13 (5): 757. PubMed Abstract | Publisher Full Text | Free Full Text 6. Byatnal AA, Rakheja M, Byatnal AR, et al. : An infiltrative angioarchitectural variant of arteriovenous malformation of temporalis. J Clin Diagn Res. 2014 Sep; 8 (9): ZD04–ZD06. PubMed Abstract | Publisher Full Text 7. Chelliah MP, Do HM, Zinn Z, et al. : Management of complex arteriovenous malformations using a novel combination therapeutic algorithm. JAMA Dermatol. 2018; 154 (11): 1316–1319. PubMed Abstract | Publisher Full Text | Free Full Text 8. Pekkola J, Lappalainen K, Vuola P, et al. : Head and neck arteriovenous malformations: results of ethanol sclerotherapy. AJNR Am J Neuroradiol. 2013 Jan; 34 (1): 198–204. PubMed Abstract | Publisher Full Text | Free Full Text 9. Ros de San Pedro J, Cuartero Pérez B, Ferri Ñíguez B, et al. : Arteriovenous Malformations of the Temporalis Muscle: A Comprehensive Review. Oper Neurosurg (Hagerstown). 2018 Apr 1; 14 (4): 325–340. PubMed Abstract | Publisher Full Text 10. Pompa V, Valentini V, Pompa G, et al. : Treatment of high-flow arteriovenous malformations (AVMs) of the head and neck with embolization and surgical resection. Ann Ital Chir. 2011; 82 (4): 253–259. PubMed Abstract 11. Lu L, Bischoff J, Mulliken JB, et al. : Increased Endothelial Progenitor Cells and Vasculogenic Factors in Higher-Staged Arteriovenous Malformations. Plast Reconstr Surg. 2011; 128 (4): 260e–269e. PubMed Abstract | Publisher Full Text | Free Full Text 12. Balakrishnan T, Ilayakumar P, Vijay B, et al. : Regulating Microvascular Free Flaps Reconstruction in “Schobinger Stage 4” Arteriovenous Malformations of Face. Indian J Plast Surg. 2023; 56 (3): 218–227. PubMed Abstract | Publisher Full Text | Free Full Text 13. Le Fourn É, Herbreteau D, Papagiannaki C, et al. : Efficacy and safety of embolization in arteriovenous malformations of the extremities and head and neck: a retrospective study of 32 cases. Eur J Dermatol. 2015 Jan; 25 (1): 52–56. PubMed Abstract | Publisher Full Text 14. Chimona TS, Papadakis CE, Hatzidakis AA, et al. : Arteriovenous malformation of the floor of the mouth: a case report.Eur Arch Otorhinolaryngol.2005 Nov; 262 (11):939–942. PubMed Abstract | Publisher Full Text 15. Cuong TC, Thang LM, Giang NL, et al. : Recurrent head and neck arteriovenous malformations: A case report.Radiol Case Rep.2023 Mar; 18 (3):766–770. PubMed Abstract | Publisher Full Text | Free Full Text 16. Ferrés-Amat E, Prats-Armengol J, Maura-Solivellas I, et al. : Gingival bleeding of a high-flow mandibular arteriovenous malformation in a child with 8-year follow-up.Case Rep Pediatr.2015; 2015 : 745718. Publisher Full Text 17. Han HH, Choi JS, Seo BF, et al. : Successful treatment of posttraumatic arteriovenous malformation of the lower lip.J Craniofac Surg.2015 May; 26 (3):e199–e201. PubMed Abstract | Publisher Full Text 18. Hosny AS, Elmahrouky A, Balboula A, et al. : Feasibility of vessel sealing devices in surgical excision of vascular malformations– novel approach. Int J Surg Open. 2020; 23 :8–16. Publisher Full Text 19. Koshima I, Nanba Y, Tsutsui T, et al. : Free perforator flap for the treatment of defects after resection of huge arteriovenous malformations in the head and neck regions.Ann Plast Surg.2003 Aug; 51 (2):194–199. PubMed Abstract | Publisher Full Text 20. Lee YS, Goh EK, Nam SB, et al. : Multidisciplinary approach to lethal bleeding from an arteriovenous malformation in the external auditory canal.J Craniofac Surg.2013 Nov; 24 (6):2179–2182. PubMed Abstract | Publisher Full Text 21. Lilje D, Wiesmann M, Hasan D, et al. : Interventional embolization combined with surgical resection for treatment of extracranial AVM of the head and neck: A monocentric retrospective analysis. PLoS One. 2022; 17 (9): e0273018. PubMed Abstract | Publisher Full Text | Free Full Text 22. Martines F, Immordino V: Arteriovenous malformation of the base of tongue in pregnancy: case report.Acta Otorhinolaryngol Ital.2009 Oct; 29 (5):274–278. PubMed Abstract | Free Full Text 23. Prasad KC, Padmanabhank, Malhotra N, et al. : Arterio venous malformation of the nose and forehead.Indian J Otolaryngol Head Neck Surg.2004 Oct; 56 (4):321–323. PubMed Abstract | Publisher Full Text | Free Full Text 24. Richter GT, Suen JY: Clinical course of arteriovenous malformations of the head and neck: A case series.Otolaryngol--Head Neck Surg.2010 Feb; 142 (2):184–190. PubMed Abstract | Publisher Full Text 25. Putra AW, Indrasari SR, Herdini C, et al. : Table 1. Baseline Characteristic. figshare. Figure. 2024. Publisher Full Text 26. Putra AW, Indrasari SR, Herdini C, et al. : PRISMA_checklist.pdf. figshare. 2024. Publisher Full Text 27. Putra AW, Indrasari SR, Herdini C, et al. : PRISMA_Flowchart. figshare. Figure. 2024. Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 27 Jun 2024 ADD YOUR COMMENT Comment Author details Author details 1 Dr. Sardjito General Hospital, Sleman, Yogyakarta, 55281, Indonesia 2 Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, Yogyakarta, 55281, Indonesia Agustian Winarno Putra Roles: Conceptualization, Investigation, Methodology, Project Administration, Software, Writing – Original Draft Preparation, Writing – Review & Editing Sagung Rai Indrasari Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Resources, Supervision, Validation, Writing – Review & Editing Camelia Herdini Roles: Methodology, Supervision, Validation, Writing – Review & Editing Danu Yudistira Roles: Methodology, Software, Supervision, Validation, Visualization, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 24 Dec 2024, 13:697 https://doi.org/10.12688/f1000research.147233.2 version 1 Published: 27 Jun 2024, 13:697 https://doi.org/10.12688/f1000research.147233.1 Copyright © 2024 Putra AW et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Putra AW, Indrasari SR, Herdini C and Yudistira D. Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.12688/f1000research.147233.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 24 Dec 2024 Revised Views 0 Cite How to cite this report: Ismail M. Reviewer Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.175581.r352426 ) The direct URL for this report is: https://f1000research.com/articles/13-697/v2#referee-response-352426 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 02 Jan 2025 Mustafa Ismail , University of Baghdad, Baghdad, Iraq Approved VIEWS 0 https://doi.org/10.5256/f1000research.175581.r352426 Thank you for making the required ... Continue reading READ ALL Thank you for making the required revision. 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COPY CITATION DETAILS Report a concern Author Response 03 Jan 2025 Agustian Winarno Putra , Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia 03 Jan 2025 Author Response Thank you for your review Competing Interests: No competing interests were disclosed. Thank you for your review Thank you for your review Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 03 Jan 2025 Agustian Winarno Putra , Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia 03 Jan 2025 Author Response Thank you for your review Competing Interests: No competing interests were disclosed. Thank you for your review Thank you for your review Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: de Bree R. Reviewer Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.175581.r352427 ) The direct URL for this report is: https://f1000research.com/articles/13-697/v2#referee-response-352427 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 31 Dec 2024 Remco de Bree , Utrecht University, Utrecht, The Netherlands Approved VIEWS 0 https://doi.org/10.5256/f1000research.175581.r352427 My questions are sufficiently answered. ... Continue reading READ ALL My questions are sufficiently answered. I recommend approval of this manuscript. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Head and neck cancer I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT de Bree R. Reviewer Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.175581.r352427 ) The direct URL for this report is: https://f1000research.com/articles/13-697/v2#referee-response-352427 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 03 Jan 2025 Agustian Winarno Putra , Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia 03 Jan 2025 Author Response Thank you for your review Competing Interests: No competing interests were disclosed. Thank you for your review Thank you for your review Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 03 Jan 2025 Agustian Winarno Putra , Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia 03 Jan 2025 Author Response Thank you for your review Competing Interests: No competing interests were disclosed. Thank you for your review Thank you for your review Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 27 Jun 2024 Views 0 Cite How to cite this report: Ismail M. Reviewer Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.161404.r339828 ) The direct URL for this report is: https://f1000research.com/articles/13-697/v1#referee-response-339828 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 Nov 2024 Mustafa Ismail , University of Baghdad, Baghdad, Iraq Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.161404.r339828 The systematic review on extracranial arteriovenous malformations (AVMs) provides valuable insights into recurrence rates following various treatment modalities, with an emphasis on the benefits of a multi-modality approach. However, it could be enhanced by addressing a few points. Firstly, the ... Continue reading READ ALL The systematic review on extracranial arteriovenous malformations (AVMs) provides valuable insights into recurrence rates following various treatment modalities, with an emphasis on the benefits of a multi-modality approach. However, it could be enhanced by addressing a few points. Firstly, the discussion on the role of reconstruction with well-vascularized tissue after surgical excision should be expanded to explore its potential in minimizing local hypoxia and reducing recurrence. Secondly, the interpretation of cure and recurrence rates might benefit from clarifying follow-up duration variations and their impact on outcomes. Lastly, incorporating long-term follow-up data and analyzing outcomes across diverse demographic groups could further substantiate the findings. - Please recheck the PRISMA diagram for No of studies exclusion. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Partly Are the conclusions drawn adequately supported by the results presented in the review? Yes If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Neurosurgery I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Ismail M. Reviewer Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.161404.r339828 ) The direct URL for this report is: https://f1000research.com/articles/13-697/v1#referee-response-339828 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 24 Dec 2024 Agustian Winarno Putra , Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia 24 Dec 2024 Author Response First of all, we would like to thank Mustafa Ismail for the detailed review, which has greatly improved this publication - Firstly, the discussion on the role of reconstruction ... Continue reading First of all, we would like to thank Mustafa Ismail for the detailed review, which has greatly improved this publication - Firstly, the discussion on the role of reconstruction with well-vascularized tissue after surgical excision should be expanded to explore its potential in minimizing local hypoxia and reducing recurrence. Secondly, the interpretation of cure and recurrence rates might benefit from clarifying follow-up duration variations and their impact on outcomes. Lastly, incorporating long-term follow-up data and analyzing outcomes across diverse demographic groups could further substantiate the findings. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period this evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n While this topic has piqued our interest, we believe it warrants a more detailed review and in-depth discussion in a separate publication. - Please recheck the PRISMA diagram for No of studies exclusion. During the revision process, we re-evaluated all the data and found an error in our initial assessment. Specifically, we mistakenly stated that 33 studies were excluded, resulting in 19 studies being included in the final analysis. In fact, 32 studies were excluded, and 20 studies were included in the final analysis. There are no changes to the actual number of final patients eligible for analysis. We apologize for the error in which we incorrectly stated that the patient reported by Ferres et al. (2015) underwent both endovascular and surgical approaches. In fact, the treatment was solely via the endovascular approach using a sclerosing agent. Additionally, we rearranged the order of patients in the table to match the original publication, making it easier to cross-check the data. First of all, we would like to thank Mustafa Ismail for the detailed review, which has greatly improved this publication - Firstly, the discussion on the role of reconstruction with well-vascularized tissue after surgical excision should be expanded to explore its potential in minimizing local hypoxia and reducing recurrence. Secondly, the interpretation of cure and recurrence rates might benefit from clarifying follow-up duration variations and their impact on outcomes. Lastly, incorporating long-term follow-up data and analyzing outcomes across diverse demographic groups could further substantiate the findings. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period this evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n While this topic has piqued our interest, we believe it warrants a more detailed review and in-depth discussion in a separate publication. - Please recheck the PRISMA diagram for No of studies exclusion. During the revision process, we re-evaluated all the data and found an error in our initial assessment. Specifically, we mistakenly stated that 33 studies were excluded, resulting in 19 studies being included in the final analysis. In fact, 32 studies were excluded, and 20 studies were included in the final analysis. There are no changes to the actual number of final patients eligible for analysis. We apologize for the error in which we incorrectly stated that the patient reported by Ferres et al. (2015) underwent both endovascular and surgical approaches. In fact, the treatment was solely via the endovascular approach using a sclerosing agent. Additionally, we rearranged the order of patients in the table to match the original publication, making it easier to cross-check the data. Competing Interests: no competing interest Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 24 Dec 2024 Agustian Winarno Putra , Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia 24 Dec 2024 Author Response First of all, we would like to thank Mustafa Ismail for the detailed review, which has greatly improved this publication - Firstly, the discussion on the role of reconstruction ... Continue reading First of all, we would like to thank Mustafa Ismail for the detailed review, which has greatly improved this publication - Firstly, the discussion on the role of reconstruction with well-vascularized tissue after surgical excision should be expanded to explore its potential in minimizing local hypoxia and reducing recurrence. Secondly, the interpretation of cure and recurrence rates might benefit from clarifying follow-up duration variations and their impact on outcomes. Lastly, incorporating long-term follow-up data and analyzing outcomes across diverse demographic groups could further substantiate the findings. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period this evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n While this topic has piqued our interest, we believe it warrants a more detailed review and in-depth discussion in a separate publication. - Please recheck the PRISMA diagram for No of studies exclusion. During the revision process, we re-evaluated all the data and found an error in our initial assessment. Specifically, we mistakenly stated that 33 studies were excluded, resulting in 19 studies being included in the final analysis. In fact, 32 studies were excluded, and 20 studies were included in the final analysis. There are no changes to the actual number of final patients eligible for analysis. We apologize for the error in which we incorrectly stated that the patient reported by Ferres et al. (2015) underwent both endovascular and surgical approaches. In fact, the treatment was solely via the endovascular approach using a sclerosing agent. Additionally, we rearranged the order of patients in the table to match the original publication, making it easier to cross-check the data. First of all, we would like to thank Mustafa Ismail for the detailed review, which has greatly improved this publication - Firstly, the discussion on the role of reconstruction with well-vascularized tissue after surgical excision should be expanded to explore its potential in minimizing local hypoxia and reducing recurrence. Secondly, the interpretation of cure and recurrence rates might benefit from clarifying follow-up duration variations and their impact on outcomes. Lastly, incorporating long-term follow-up data and analyzing outcomes across diverse demographic groups could further substantiate the findings. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period this evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n While this topic has piqued our interest, we believe it warrants a more detailed review and in-depth discussion in a separate publication. - Please recheck the PRISMA diagram for No of studies exclusion. During the revision process, we re-evaluated all the data and found an error in our initial assessment. Specifically, we mistakenly stated that 33 studies were excluded, resulting in 19 studies being included in the final analysis. In fact, 32 studies were excluded, and 20 studies were included in the final analysis. There are no changes to the actual number of final patients eligible for analysis. We apologize for the error in which we incorrectly stated that the patient reported by Ferres et al. (2015) underwent both endovascular and surgical approaches. In fact, the treatment was solely via the endovascular approach using a sclerosing agent. Additionally, we rearranged the order of patients in the table to match the original publication, making it easier to cross-check the data. Competing Interests: no competing interest Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: de Bree R. Reviewer Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.161404.r326069 ) The direct URL for this report is: https://f1000research.com/articles/13-697/v1#referee-response-326069 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 30 Sep 2024 Remco de Bree , Utrecht University, Utrecht, The Netherlands Approved VIEWS 0 https://doi.org/10.5256/f1000research.161404.r326069 This manuscript is about the recurrence rate after treatment of extracranial AVMs in the head and neck area. This systematic review is well performed and the manuscript is well written. The outcomes are focuses on recurrence. Limitations of the ... Continue reading READ ALL This manuscript is about the recurrence rate after treatment of extracranial AVMs in the head and neck area. This systematic review is well performed and the manuscript is well written. The outcomes are focuses on recurrence. Limitations of the study are described. I have only three minor points - - 'Currently, in our literature search, the management of AVMs mass shows a better recurrence rate than previously believed'. Please change 'better' in 'lower'. - The aim is to emboloize the nidus, which is very difficult. If embolization is the only treatment this is very important. If it is performed pre-operatively it is less important, than embolization of the feeding arteries may be enough. - Can the authors discuss the reconstruction of the defect after surgical excision. There are suggestions that reconstruction with well vascularized tissue (thus avoiding local hypoxia) may reduce the risk of recurrence. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Yes Are the conclusions drawn adequately supported by the results presented in the review? Yes If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Head and neck cancer I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT de Bree R. Reviewer Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.161404.r326069 ) The direct URL for this report is: https://f1000research.com/articles/13-697/v1#referee-response-326069 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 24 Dec 2024 Agustian Winarno Putra , Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia 24 Dec 2024 Author Response First of all, we would like to thank Remco de Bree the detailed review, which has greatly improved this publication - 'Currently, in our literature search, the management of ... Continue reading First of all, we would like to thank Remco de Bree the detailed review, which has greatly improved this publication - 'Currently, in our literature search, the management of AVMs mass shows a better recurrence rate than previously believed'. Please change 'better' in 'lower'. We already make adjustment a suggested - The aim is to emboloize the nidus, which is very difficult. If embolization is the only treatment this is very important. If it is performed pre-operatively it is less important, than embolization of the feeding arteries may be enough. - Can the authors discuss the reconstruction of the defect after surgical excision. There are suggestions that reconstruction with well vascularized tissue (thus avoiding local hypoxia) may reduce the risk of recurrence. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period This evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n Thank you First of all, we would like to thank Remco de Bree the detailed review, which has greatly improved this publication - 'Currently, in our literature search, the management of AVMs mass shows a better recurrence rate than previously believed'. Please change 'better' in 'lower'. We already make adjustment a suggested - The aim is to emboloize the nidus, which is very difficult. If embolization is the only treatment this is very important. If it is performed pre-operatively it is less important, than embolization of the feeding arteries may be enough. - Can the authors discuss the reconstruction of the defect after surgical excision. There are suggestions that reconstruction with well vascularized tissue (thus avoiding local hypoxia) may reduce the risk of recurrence. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period This evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n Thank you Competing Interests: - Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 24 Dec 2024 Agustian Winarno Putra , Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia 24 Dec 2024 Author Response First of all, we would like to thank Remco de Bree the detailed review, which has greatly improved this publication - 'Currently, in our literature search, the management of ... Continue reading First of all, we would like to thank Remco de Bree the detailed review, which has greatly improved this publication - 'Currently, in our literature search, the management of AVMs mass shows a better recurrence rate than previously believed'. Please change 'better' in 'lower'. We already make adjustment a suggested - The aim is to emboloize the nidus, which is very difficult. If embolization is the only treatment this is very important. If it is performed pre-operatively it is less important, than embolization of the feeding arteries may be enough. - Can the authors discuss the reconstruction of the defect after surgical excision. There are suggestions that reconstruction with well vascularized tissue (thus avoiding local hypoxia) may reduce the risk of recurrence. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period This evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n Thank you First of all, we would like to thank Remco de Bree the detailed review, which has greatly improved this publication - 'Currently, in our literature search, the management of AVMs mass shows a better recurrence rate than previously believed'. Please change 'better' in 'lower'. We already make adjustment a suggested - The aim is to emboloize the nidus, which is very difficult. If embolization is the only treatment this is very important. If it is performed pre-operatively it is less important, than embolization of the feeding arteries may be enough. - Can the authors discuss the reconstruction of the defect after surgical excision. There are suggestions that reconstruction with well vascularized tissue (thus avoiding local hypoxia) may reduce the risk of recurrence. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period This evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n Thank you Competing Interests: - Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 27 Jun 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 2 (revision) 24 Dec 24 read read Version 1 27 Jun 24 read read Remco de Bree , Utrecht University, Utrecht, The Netherlands Mustafa Ismail , University of Baghdad, Baghdad, Iraq Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Ismail M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 02 Jan 2025 | for Version 2 Mustafa Ismail , University of Baghdad, Baghdad, Iraq 0 Views copyright © 2025 Ismail M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for making the required revision. I have no further comments. Competing Interests No competing interests were disclosed. Reviewer Expertise Neurosurgery I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 03 Jan 2025 Agustian Winarno Putra, Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia Thank you for your review View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Ismail M. Peer Review Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.175581.r352426) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-697/v2#referee-response-352426 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 de Bree R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 31 Dec 2024 | for Version 2 Remco de Bree , Utrecht University, Utrecht, The Netherlands 0 Views copyright © 2025 de Bree R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions My questions are sufficiently answered. I recommend approval of this manuscript. Competing Interests No competing interests were disclosed. Reviewer Expertise Head and neck cancer I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 03 Jan 2025 Agustian Winarno Putra, Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia Thank you for your review View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern de Bree R. Peer Review Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.175581.r352427) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-697/v2#referee-response-352427 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Ismail M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 Nov 2024 | for Version 1 Mustafa Ismail , University of Baghdad, Baghdad, Iraq 0 Views copyright © 2024 Ismail M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The systematic review on extracranial arteriovenous malformations (AVMs) provides valuable insights into recurrence rates following various treatment modalities, with an emphasis on the benefits of a multi-modality approach. However, it could be enhanced by addressing a few points. Firstly, the discussion on the role of reconstruction with well-vascularized tissue after surgical excision should be expanded to explore its potential in minimizing local hypoxia and reducing recurrence. Secondly, the interpretation of cure and recurrence rates might benefit from clarifying follow-up duration variations and their impact on outcomes. Lastly, incorporating long-term follow-up data and analyzing outcomes across diverse demographic groups could further substantiate the findings. - Please recheck the PRISMA diagram for No of studies exclusion. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Partly Are the conclusions drawn adequately supported by the results presented in the review? Yes If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Neurosurgery I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 24 Dec 2024 Agustian Winarno Putra, Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia First of all, we would like to thank Mustafa Ismail for the detailed review, which has greatly improved this publication - Firstly, the discussion on the role of reconstruction with well-vascularized tissue after surgical excision should be expanded to explore its potential in minimizing local hypoxia and reducing recurrence. Secondly, the interpretation of cure and recurrence rates might benefit from clarifying follow-up duration variations and their impact on outcomes. Lastly, incorporating long-term follow-up data and analyzing outcomes across diverse demographic groups could further substantiate the findings. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period this evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n While this topic has piqued our interest, we believe it warrants a more detailed review and in-depth discussion in a separate publication. - Please recheck the PRISMA diagram for No of studies exclusion. During the revision process, we re-evaluated all the data and found an error in our initial assessment. Specifically, we mistakenly stated that 33 studies were excluded, resulting in 19 studies being included in the final analysis. In fact, 32 studies were excluded, and 20 studies were included in the final analysis. There are no changes to the actual number of final patients eligible for analysis. We apologize for the error in which we incorrectly stated that the patient reported by Ferres et al. (2015) underwent both endovascular and surgical approaches. In fact, the treatment was solely via the endovascular approach using a sclerosing agent. Additionally, we rearranged the order of patients in the table to match the original publication, making it easier to cross-check the data. View more View less Competing Interests no competing interest reply Respond Report a concern Ismail M. Peer Review Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.161404.r339828) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-697/v1#referee-response-339828 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 de Bree R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 30 Sep 2024 | for Version 1 Remco de Bree , Utrecht University, Utrecht, The Netherlands 0 Views copyright © 2024 de Bree R. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This manuscript is about the recurrence rate after treatment of extracranial AVMs in the head and neck area. This systematic review is well performed and the manuscript is well written. The outcomes are focuses on recurrence. Limitations of the study are described. I have only three minor points - - 'Currently, in our literature search, the management of AVMs mass shows a better recurrence rate than previously believed'. Please change 'better' in 'lower'. - The aim is to emboloize the nidus, which is very difficult. If embolization is the only treatment this is very important. If it is performed pre-operatively it is less important, than embolization of the feeding arteries may be enough. - Can the authors discuss the reconstruction of the defect after surgical excision. There are suggestions that reconstruction with well vascularized tissue (thus avoiding local hypoxia) may reduce the risk of recurrence. Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes Are sufficient details of the methods and analysis provided to allow replication by others? Yes Is the statistical analysis and its interpretation appropriate? Yes Are the conclusions drawn adequately supported by the results presented in the review? Yes If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.) Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Head and neck cancer I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 24 Dec 2024 Agustian Winarno Putra, Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Nursing, and Public Health Universitas Gadjah Mada, Sleman, 55281, Indonesia First of all, we would like to thank Remco de Bree the detailed review, which has greatly improved this publication - 'Currently, in our literature search, the management of AVMs mass shows a better recurrence rate than previously believed'. Please change 'better' in 'lower'. We already make adjustment a suggested - The aim is to emboloize the nidus, which is very difficult. If embolization is the only treatment this is very important. If it is performed pre-operatively it is less important, than embolization of the feeding arteries may be enough. - Can the authors discuss the reconstruction of the defect after surgical excision. There are suggestions that reconstruction with well vascularized tissue (thus avoiding local hypoxia) may reduce the risk of recurrence. We added a publication by Balakrishnan et al (2023.) in the publication it indicates that free flaps, offering a robust and uniform blood supply, are significantly more effective in preventing recurrence compared to pedicled flaps or skin grafts. One study highlighted a 0% recurrence rate with free flaps, in contrast to a 64% recurrence rate with pedicled flaps and grafts. Additionally, patients undergoing reconstruction with free flaps after wide local excision achieved markedly better functional and aesthetic outcomes, with 87.5% reporting good-to-excellent results and no recurrences observed during the follow-up period This evidence is back up with the theory from Lu et al (2011) that stated recurrence of AVMs is often associated with neovascularization driven by factors such as hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF. These factors are upregulated in hypoxic conditions, promoting the recruitment of endothelial progenitor cells and new vessel formatio n Thank you View more View less Competing Interests - reply Respond Report a concern de Bree R. Peer Review Report For: Unveiling The Myth of High Recurrence Rate of Extracranial Arteriovenous Malformations of The Head and Neck: Systematic Review of Case Reports and Case Series [version 2; peer review: 2 approved] . F1000Research 2024, 13 :697 ( https://doi.org/10.5256/f1000research.161404.r326069) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-697/v1#referee-response-326069 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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