title: Doxycycline sclerotherapy for pediatric head and neck macrocystic lymphatic malformations: a case series and review of the literature.
abstract: OBJECTIVE
  (a) To evaluate the efficacy of doxycycline as a percutaneous sclerotherapy agent in pediatric head and neck macrocystic lymphatic malformations (LM) and (b) to review the literature with regard to recent developments in the treatment of lymphatic malformations using sclerotherapy.
  
  
  METHODS
  We reviewed the medical records and imaging studies of all patients who underwent percutaneous sclerotherapy of macrocystic LM of the head and neck at our institution between June 2005 and May 2010. All studies were reviewed and procedures performed by a single interventional neuroradiologist using computed tomography (CT) guidance. LM were individually cannulated, the contents aspirated, and then injected with doxycycline at concentrations of 10-20 mg/ml. Response to sclerotherapy was determined clinically.
  
  
  RESULTS
  Seven patients underwent a total of eight sclerotherapy treatments during the study period. Of the six patients with appropriate follow-up, 67% have experienced complete or near-complete clinical resolution of their LM (1243 days mean follow-up), while 33% have developed recurrent swelling after an initial response following a single doxycycline injection (53 days mean follow-up).
  
  
  CONCLUSIONS
  Our institutional results, in combination with recently published findings, support the moderate efficacy and excellent safety profile of percutaneous doxycycline sclerotherapy for macrocystic lymphatic malformations.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY 10467, USA. nausheen.jamal@gmail.com
authors.forename: Nausheen
authors.initials: N
authors.lastname: Jamal
authors.forename: Sameer
authors.initials: S
authors.lastname: Ahmed
authors.forename: Todd
authors.initials: T
authors.lastname: Miller
authors.forename: John
authors.initials: J
authors.lastname: Bent
authors.forename: Allan
authors.initials: A
authors.lastname: Brook
authors.forename: Sanjay
authors.initials: S
authors.lastname: Parikh
authors.forename: Ashish
authors.initials: A
authors.lastname: Ankola
mesh_terms: D002648:Child; D002675:Child, Preschool; D004318:Doxycycline / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D008202:Lymphangioma / Q000000981:diagnostic imaging / Q000628:therapy*; D044148:Lymphatic Abnormalities / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004318:Doxycycline