title: Considerations for Management of Head and Neck Lymphatic Malformations in Children.
abstract: OBJECTIVE
  There exist inherent problems with previously described classification schemes for head and neck lymphatic malformations in children and lack of guidance for management. An organization scheme and management recommendations are proposed to improve communication between health care providers.
  
  
  METHODS
  Consecutive patient series with a chart review of children with head and neck lymphatic malformations.
  
  
  METHODS
  Tertiary-care, academic children's hospital.
  
  
  METHODS
  Children with lymphatic malformations of the head and neck were included. A proposed organization system for head and neck lymphatic malformations in children was developed and compared to 2 others currently predominantly used, de Serres and Cologne Disease Score.
  
  
  RESULTS
  Seventeen patients were identified, 7 boys and 10 girls. The mean age was 64.4 months (range 0.89-185.5). Nine patients (52.9%) were managed expectantly, 5 (29.4%) with sclerotherapy with 1 awaiting treatment (5.9%), and 2 (11.8%) with surgical excision. All children who underwent active treatment with surgery or sclerotherapy were managed successfully. No treatment-related complications were encountered, and no children managed with watchful waiting/expectant management experienced failure. The proposed staging system differed from the de Serres stage in 11 children (64.7%), with 9 (81.8%) being down staged and 2 (18.2%) up staged. Cologne Disease Score ranged from 2 to 10, with only 1 (5.9%) patient with a score of 3 or less (severe disease).
  
  
  CONCLUSIONS
  Treatment recommendations in children with head and neck lymphatic malformations should be individualized. Weaknesses of currently used staging systems are discussed as well as considerations for management decisions.
authors.affiliation: *Division of Pediatric Otolaryngology, Cohen Children's Medical Center, New Hyde Park †Department of Otolaryngology - Head and Neck Surgery, Northwell Health School of Medicine ‡Division of Plastic Surgery, Cohen Children's Medical Center §Department of Surgery, Hofstra Northwell Health School of Medicine, Hempstead, NY.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Cheng
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bastidas
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006257:Head / Q000601:surgery; D006801:Humans; D007223:Infant; D044148:Lymphatic Abnormalities / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D009333:Neck / Q000601:surgery; D010038:Otorhinolaryngologic Diseases / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D013517:Otorhinolaryngologic Surgical Procedures; D015911:Sclerotherapy; D016896:Treatment Outcome; D057832:Watchful Waiting