Individualized Management of Low-Flow Maxillofacial Vascular Malformations: Case Reports Integrated with an Evidence-Based Narrative Synthesis

Vascular anomalies (VAs) in the maxillofacial region represent a diagnostic and therapeutic challenge due to their complex angioarchitecture and the risk of severe hemorrhage. According to the International Society for the Study of Vascular Anomalies (ISSVA), these are categorized into vascular tumors and malformations. While clinical management has traditionally relied on surgery and sclerotherapy, innovative bioelectrical and electrochemical modalities are emerging as effective alternatives. This study employed an integrated bimodal framework, combining a systematic narrative synthesis of 42 high-impact articles with a retrospective analysis of five individualized clinical cases (n = 5). Diagnostic accuracy was ensured through a standardized triad including clinical phenotyping, color Doppler ultrasound, and contrast-enhanced computed tomography (CT). The clinical application of individualized protocols—including 3% polidocanol, copper tip-induced thrombosis, and nonthermal plasma (NTP)—resulted in total lesion stability (100% success rate) without significant adverse events. NTP application (13.56 MHz; 15 W) in complex cases (e.g., Sjögren’s disease) showed superior tissue regeneration and accelerated fibroplasia. The convergence of international evidence and clinical experience validates the efficacy of a graded therapeutic algorithm for low-flow malformations. This individualized protocol acts as a new treatment approach with special benefits over conventional treatment methods, being supported by both clinical evidence and advanced diagnostic mapping. This synergy offers a robust foundation for future prospective trials in maxillofacial surgery.