Head and neck lymphatic malformation treatment: a systematic review.
OBJECTIVE
To systematically review literature pertaining to head and neck lymphatic malformation treatment and to use individual-level data presented in qualifying case series to describe the reported efficacy, complications, and functional impact of surgery and sclerotherapy. The authors evaluated whether treatment modalities differ by lymphatic malformation stage.


METHODS
The terms lymphangioendothelioma, lymphangioma, cystic hygroma, and malformation were used to perform an Ovid literature search yielding 6292 references. The authors excluded references that did not involve head and neck lymphatic malformation treatment, include at least 5 patients, follow patients 1 year, define treatment modality, and state complications.


METHODS
The authors summarized data from 1205 patients reported in 41 articles. Individual-level data, in the 29 articles reporting these data, were pooled and tabulated.


RESULTS
The absence of within-study comparisons of treatment success, as well as the range of reporting methods, precluded a formal meta-analysis. Most reports were case series (37; 90%). The primary treatment modality was sclerotherapy in 17 (41%), surgery in 16 (39%), or surgery combined with other modalities in 9 (20%). Individual-level data were captured for 283 patients. No treatment modality clearly resulted in superior treatment outcome. Complications were more frequent in surgical series but were reported inconsistently in sclerotherapy studies.


CONCLUSIONS
There is evidence that lymphatic malformation treatment can be done effectively with surgery or sclerotherapy, but further study is necessary to determine which is superior. Standardized guidelines for reporting lymphatic malformation case series do not currently exist, making comparison of treatment outcomes of differing treatment modalities difficult.
Department of Otolaryngology, Madigan Army Medical Center, Tacoma, Washington, USA.
Mary Theresa
MT
Adams
Babette
B
Saltzman
Jonathan A
JA
Perkins
D003131:Combined Modality Therapy; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D044148:Lymphatic Abnormalities / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D011183:Postoperative Complications; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods
D012597:Sclerosing Solutions