title: Sodium tetradecyl sulphate sclerotherapy for treating venous malformations of the oral and pharyngeal regions in children.
abstract: OBJECTIVE
  Venous vascular malformations in the head and neck region present a difficult management challenge. We describe our experience of using sodium tetradecyl sulphate injection sclerotherapy to treat children presenting with venous malformations of the oral and pharyngeal region.
  
  
  METHODS
  We performed a retrospective case note review of consecutive children treated at our institution between 2004 and 2011. Patient notes were analysed for demographic details, site and size of lesion, number and duration of treatments, treatment response and complications.
  
  
  RESULTS
  Twelve patients were included (7 boys and 5 girls, mean age 7 years). Sites of lesions included tongue, floor of mouth, pharynx, tonsillar fossae, parapharyngeal space and soft palate. All patients were treated with 3% sodium tetradecyl sulphate (STS) foam injected trans-orally or percutaneously under ultrasound or fluoroscopic guidance. The lesions had a mean volume of 4 ml (range 2-14 ml). An average of 3 treatments was required (range 1-9). In 4 patients a single treatment was sufficient. For those patients requiring multiple treatments, a mean of 4 treatments were required over an average period of 28 months. The overall response rate was 83% (10/12). Complete resolution was achieved in 4 cases (33%) with a significant reduction in size in a further 6 cases (50%). Larger lesions generally require more treatments than low volume lesions. Two cases recurred despite treatment. One patient suffered minor bleeding following transcutaneous injection.
  
  
  CONCLUSIONS
  Injection sclerotherapy using STS foam offers an effective treatment option when managing children presenting with venous malformations in the oral and pharyngeal. A single treatment may be adequate for small lesions but the procedure may be safely repeated until a satisfactory result is obtained.
authors.affiliation: Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK. paul.stimpson@doctors.org.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Stimpson
authors.forename: Richard
authors.initials: R
authors.lastname: Hewitt
authors.forename: Alex
authors.initials: A
authors.lastname: Barnacle
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Roebuck
authors.forename: Ben
authors.initials: B
authors.lastname: Hartley
mesh_terms: D002648:Child; D004724:Endoscopy; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D009059:Mouth Diseases / Q000473:pathology / Q000628:therapy*; D010608:Pharyngeal Diseases / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage*; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000473:pathology / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate