Noninterventional treatment of selected head and neck lymphatic malformations.
BACKGROUND
Indications for treatment of lymphatic malformations include disfigurement, symptoms, and infection. Patients with lymphatic malformations often undergo resection or sclerotherapy to prevent possible complications, as it has been thought that lymphatic lesions do not regress.


METHODS
A retrospective analysis of all head and neck lymphatic malformations for the past 5 years was performed.


RESULTS
Twenty-five patients with lymphatic malformations of the head and neck were treated, all underwent computed tomography or magnetic resonance imaging for evaluation. Fourteen patients had macrocystic lesions; others were considered mixed or microcystic. Seventeen patients underwent intervention. Ten patients underwent surgical resection alone, 4 patients underwent sclerotherapy, and 3 patients had both sclerotherapy and surgical resection. Of 17, 15 patients who underwent intervention had complications, including recurrence and nerve damage. Eight patients with predominantly macrocystic lesions were managed with close observation and were asymptomatic other than a mass. With follow-up of 33.4 months, in 4 of 8 patients, the lesion significantly decreased; 4 of 8 patients continue to be asymptomatic.


CONCLUSIONS
Patients who undergo intervention have a high complication and recurrence rate. Selected patients with asymptomatic macrocystic lymphatic malformations of the head and neck can often be managed by observation alone. These patients should be followed closely in a multidiscliplinary clinical setting.
Dasgupta
Roshni
R
Hemangioma and Vascular Malfomations Center, Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Medical Center, Cincinnati, OH 45229, USA. roshni.dasgupta@cchmc.org
Adams
Denise
D
Elluru
Ravindhra
R
Wentzel
Mary Sue
MS
Azizkhan
Richard G
RG
D005260:Female; D005500:Follow-Up Studies; D006257:Head; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008197:Lymph Node Excision; D044148:Lymphatic Abnormalities / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008423:Maternal Age; D009333:Neck; D011247:Pregnancy; D012008:Recurrence; D012189:Retrospective Studies; D015911:Sclerotherapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome