Basic and patient-oriented researchSclerotherapy of Microcystic Lymphatic Malformations in Oral and Facial Regions
Section snippets
Patients and Methods
Intralesional injection of pingyangmycin was used to treat 103 children with LMs between January 1985 and December 2005. In general, when damage to local structures was a concern or lesions were too extensive for complete excision, pingyangmycin sclerotherapy was recommended as the primary treatment. In addition, some patients were recommended to receive sclerotherapy because of residual lesions after surgery. Seventy-nine patients with follow-up of more than 6 months after the last treatment
Results
Among the 79 patients, 71 were involved with 2 or more anatomic sites and the other 8 developed lesions only involving a single site. The total number of injections performed was 386, and the median number of injections per patient was 4.2 (range, 3 to 8). Median duration of follow-up was 2 years, 8 months (range, 6 months to 79 months).
Overall, in this series, 44 patients (55.70%) were graded as cured (Fig 1) or near-normal appearance, 23 (29.11%) as marked improvement (Fig 2). In the
Discussion
The primary treatment for LMs remains debatable. Many authors agree that complete surgical excision is the first choice of treatment for LMs.18, 19, 20, 21 However, surgical treatment of oral and facial LMs in children has usually been disappointing. Studies have shown that the LMs involving the tongue, floor of the mouth, cheek, pharynx, or multiple anatomic sites have more recurrences, require more procedures, have higher complication rates, and were left with persistent symptomatic disease.22
References (28)
- et al.
Bleomycin sclerotherapy in congenital lymphatic and vascular malformations of head and neck
Int J Pediatr Otorhinolaryngol
(2005) - et al.
Sclerotherapy for lymphangioma in children
Int J Pediatr Otorhinolaryngol
(2003) - et al.
Injection of bleomycin as a primary therapy of cystic lymphangioma
J Pediatr Surg
(1992) - et al.
Histological investigation of veins and venous malformations after injection of sclerosing agents
Asian J Oral Maxillofac Surg
(2002) - et al.
Sclerotherapy of oral and facial venous malformations with use of pingyangmycin and/or sodium morrhuate
Int J Oral Maxillofac Surg
(2004) - et al.
Surgery of lymphatic malformations in oral and cervicofacial regions in children
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2007) - et al.
A new therapeutic concept for the treatment of cystic hygroma
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1996) - et al.
OK-432 therapy in 64 patients with lymphangioma
J Pediatr Surg
(1994) - et al.
Treatment of cystic hygroma and lymphangioma with the use of bleomycin fat emulsion
Cancer
(1987) - et al.
Intracystic injection of OK-432: A new sclerosing therapy for cystic hygroma in children
Br J Surg
(1987)
Long term results of intratumorous Bleomycin-A5 injection for head and neck lymphangioma
Oral Surg Oral Med Oral Pathol
Guidelines for the successful treatment of lymphangioma with OK-432
Eur J Pediatr Surg
Bleomycin therapy for cystic hygroma
J Pediatr Surg
Percutaneous sclerotherapy of lymphangiomas
Radiology
Cited by (72)
Sclerosing agents in the management of lymphatic malformations in children: A systematic review
2022, Journal of Pediatric SurgeryManagement of vascular malformations in the Oral and maxillofacial region: A systematic review
2021, Journal of Stomatology, Oral and Maxillofacial SurgeryCitation Excerpt :In five studies, involution or the response of lesion was not mentioned [18,29,36,43,46]. Remaining studies reported mixed outcome (both involution and non-involution of the lesion) [13,14,17,19,25,30,31,33,39,40,44]. The overall outcome was assessed using cohran’s Q heterogeneity test.
Management of lymphatic vascular malformations: A systematic review of the literature
2021, Journal of Vascular Surgery: Venous and Lymphatic DisordersCitation Excerpt :Bleomycin is a chemotherapeutic antibiotic derived from the fungus Streptomyces verticillus.3 It has been shown to be effective and safe in the treatment of macrocystic LMs in many case series.20-27 In these studies, an excellent or a moderate response has been described in >70% of patients.
Vascular anomalies: Classification and management
2021, Handbook of Clinical NeurologySclerotherapy for lymphatic malformations of head and neck: Systematic review and meta-analysis
2020, Journal of Vascular Surgery: Venous and Lymphatic DisordersCitation Excerpt :On review of the abstracts and titles, we excluded 861 articles. Seventy-three articles were selected for full-text screening, of which 25 met inclusion criteria.1-7,9-14,17-28 The remaining 48 articles were excluded for reasons including failure to separate outcomes by anatomic location (9 articles); inclusion of venous or venolymphatic malformations rather than pure LMs (14 articles); use of confusing or unclear terminology, making it difficult to ascertain whether lesions were LMs or other vascular malformations (12 articles); and mixture of venous malformations, arteriovenous malformations, and LMs (13 articles).
Common (Cystic) Lymphatic Malformations: Current Knowledge and Management
2019, Techniques in Vascular and Interventional Radiology