Surgical excision of cervicofacial giant macrocystic lymphatic malformations in infants and children

Surgical excision as primary treatment modality for extensive cervicofacial lymphatic malformations in children

“…Amongst these, the patients with macrocystic disease complete/near complete response was achieved in 30/31 (96.8%) patients. In this study only minor complications were encountered in 11.3%, which is comparable to other studies [6,13]. Opting for subtotal excision for extensive or inaccessible disease will dramatically reduce the incidence of permanent nerve palsies.…”

“…Approximately 50-65% of these are present at birth, 90% are present by 2 years of age and 95% are present by adolescence [12,13]. These can present with breathing or swallowing difficulties depending on the anatomical site and extent of the lesion.…”

“…Total excision of these lesions with safety margins leads to good outcomes and has been reported as the treatment of choice [13,[15][16][17]. Other authors have advised a more conservative surgical approach [7,18].…”

Percutaneous sclerotherapy of massive macrocystic lymphatic malformations of the face and neck using fibrin glue with OK-432 and bleomycin

“…CHEN et al 6 reported that 11% of their patients (aged 7 days to 13 years; mean 2.9 years) suffered from preoperative symptoms, including haemorrhage, infection, dysphasia, and airway obstruction, that had begun almost immediately after birth. Fifteen of the patients had received conservative treatment such as intralesional injections of triamcinolone or OK-432.…”

“…The most common preoperative symptoms are intralesional haemorrhage and infection; more serious symptoms such as dysphasia and airway obstruction may also occur 6,19 . Surgical excision has been the standard treatment for such malformations 6,12,17,19 , but it has been associated in some cases with postoperative recurrence and surgical complications, such as facial nerve paralysis, bleeding or haematoma, Frey's syndrome, Stant's duct obstruction, and contour defects 6,8,17 . A variety of nonsurgical alternatives have been investigated, with the goal of reducing morbidity whilst effectively treating the lesion.…”