title: Long-term outcome of radiofrequency ablation for intraoral microcystic lymphatic malformation.
abstract: OBJECTIVE
  To determine long-term outcome of radiofrequency (RF) ablation of microcystic lymphatic malformation (LM) of the oral cavity for control of recurrent infection and bleeding.
  
  
  METHODS
  Institutional review board-approved retrospective study,
  
  
  METHODS
  Tertiary pediatric medical center,
  
  
  METHODS
  Twenty-six patients with intraoral microcystic LM were treated with RF ablation from August 2002 through August 2010.
  
  
  METHODS
  Radiofrequency ablation of intraoral LM.
  
  
  METHODS
  Postoperative stay, diet, pain; control of bleeding and/or infection; recurrence; and indication for retreatment.
  
  
  RESULTS
  The most common complaints necessitating initial RF ablation were recurrent infection (n=10 [37%]) and bleeding (n=9 [33%]). The most common problems requiring further ablation were bleeding (n=11 [41%]) and cosmetic deformity not affecting function (n=8 [31%]). Fourteen patients (55%) were discharged home on postoperative day (POD) 3; the remaining 11 (45%) were discharged home on POD 4. Thirteen patients (52%) resumed oral diet immediately on the day of the procedure. Ten patients (38%) began eating on POD 1, and virtually every patient was on full oral intake at discharge. Fourteen patients (55%) required only acetaminophen for pain control, 11 (41%) required acetaminophen with codeine, and 1 (4%) required oxycodone. The mean follow-up time was 47 months after treatment. At the most recent clinic evaluation, 13 patients (50%) were symptom free, 8 (31%) were stable and improved without need for future treatment, and 5 (19%) required further treatment. One-half of patients in the study group underwent more than 1 RF procedure for recurrence. The number of RF ablations in this series were 1 procedure (n = 13), 2 procedures (n = 7), 3 procedures (n = 2), 4 procedures (n = 2), and 6 or 7 procedures (n = 2).
  
  
  CONCLUSIONS
  Radiofrequency ablation is an effective treatment for localized, superficial microcystic LM in the oral cavity. Pediatric patients tolerate the treatment with rapid postoperative recovery and minimal complications. The majority of patients required a short hospital stay for observation of the airway. Virtually every patient resumed oral diet by the time of discharge. Radiofrequency ablation is the treatment of choice at Children's Hospital Boston (CHB) for patients who present with symptomatic, superficial, and localized intraoral microcystic LM. For lesions involving deeper structures, multimodal treatments including surgical and sclerotherapy may be necessary.
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Children's Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Sang W
authors.initials: SW
authors.lastname: Kim
authors.forename: Katie
authors.initials: K
authors.lastname: Kavanagh
authors.forename: Katie
authors.initials: K
authors.lastname: Kauvanough
authors.forename: Darren B
authors.initials: DB
authors.lastname: Orbach
authors.forename: Ahmad I
authors.initials: AI
authors.lastname: Alomari
authors.forename: John B
authors.initials: JB
authors.lastname: Mulliken
authors.forename: Reza
authors.initials: R
authors.lastname: Rahbar
mesh_terms: D000293:Adolescent; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D018191:Lymphangioma, Cystic / Q000601:surgery*; D044148:Lymphatic Abnormalities / Q000601:surgery*; D008297:Male; D009056:Mouth Abnormalities / Q000601:surgery*; D006472:Oral Hemorrhage / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D055502:Secondary Prevention; D013280:Stomatitis / Q000601:surgery*