title: Nonsurgical therapies for lymphangiomas: a systematic review.
abstract: OBJECTIVE
  Systematically review the published literature regarding the efficacy of nonsurgical therapies in the treatment of head and neck (H&N) lymphatic malformations (LM) in children.
  
  
  METHODS
  MEDLINE.
  
  
  METHODS
  MEDLINE was searched for literature relating to nonsurgical treatments for H&N LM.
  
  
  RESULTS
  The initial search returned 1876 articles, with 22 meeting criteria. The majority (20) were case series. All therapies were percutaneous, with OK-432 or bleomycin sclerotherapy being most common. Random-effects modeling revealed 43% (CI = 28.9%-57%) of patients undergoing OK-432 for LM achieved a complete/excellent response, 23.5% (CI = 5.8%-41.3%) achieved a good response, 16.9% (CI = 10.3%-23.4%) achieved a fair/poor response, and 15.4% (CI = 8.6%-22.2%) observed no response. In the bleomycin group, the results were: 35.2% (CI = 15.7%-54.6%) excellent, 37.1% (CI = 22%-52.3%) good, 18.4% (CI = 2.7%-34.2%) fair/poor, and 11.6% (CI = 3.5%-19.6%) no response. Seven major complications were noted out of the 289 patients in the series, including two mortalities.
  
  
  CONCLUSIONS
  The literature indicates that sclerotherapy for H&N LM achieves excellent/good clinical response in a majority of patients, with few complications, and anecdotally does not complicate future surgery.
authors: Department of Otolaryngology-Head and Neck Surgery, Walter Reed Army Medical Center, Washington, DC, USA.
authors: Jason L
authors: JL
authors: Acevedo
authors: Rahul K
authors: RK
authors: Shah
authors: Scott E
authors: SE
authors: Brietzke
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use*; D006801:Humans; D008202:Lymphangioma / Q000628:therapy*; D010844:Picibanil / Q000627:therapeutic use*; D015911:Sclerotherapy; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin; D010844:Picibanil