Radiofrequency in the treatment of craniofacial plexiform neurofibromatosis: a pilot study.
BACKGROUND
Neurofibromatosis type 1 manifests itself by the development of plexiform neurofibromas, with craniofacial deformities caused by bone alterations and soft-tissue infiltration. The medical treatment of this disease is disappointing, and the surgical management of these deformities calls for aggressive procedures. There is a strong risk of recurrence.


METHODS
A pilot study was performed to test radiofrequency as a minimally invasive method with which to diminish the size of craniofacial neurofibromas either as an adjunct to craniofacial surgery (in cranio-orbital neurofibromas) or to avoid a visible scar in young patients (in infraorbital neurofibromas). Five patients ranging in age from 6 to 18 years were treated by three procedures 2 months apart using radiofrequency performed under local anesthesia or under sedation for the youngest patients.


RESULTS
The tolerance of the treatment was excellent, with no major side effects and no pain in the postoperative course. A diminution of the size of the lesion was noted clinically in four patients and on computed tomography in two patients. A biopsy performed in one case illustrated the effect of the treatment.


CONCLUSIONS
A partial diminution or stabilization of plexiform neurofibromas may be obtained using radiofrequency. This treatment is well tolerated. The best effect can be observed in the early stages of the disease. The optimal dose and frequency of the procedure require further study.
Department of Head and Neck Surgery, Hôpital Foch, Suresnes, France. b.baujat@hopital-foch.org
Bertr
B
Baujat
Darina
D
Krastinova-Lolov
Marc
M
Blumen
Anne-Catherine
AC
Baglin
François
F
Coquille
Frédéric
F
Chabolle
D000293:Adolescent; D002648:Child; D004564:Electrocoagulation; D005153:Facial Neoplasms; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D018318:Neurofibroma, Plexiform / Q000209:etiology / Q000601:surgery*; D009456:Neurofibromatosis 1 / Q000150:complications; D009918:Orbital Neoplasms / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D012888:Skull Neoplasms / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*