TY - JOUR
T1 - Treatment of lymphatic malformations
T2 - A more conservative approach
AU - Gilony, Dror
AU - Schwartz, Michael
AU - Shpitzer, Thomas
AU - Feinmesser, Raphael
AU - Kornreich, Liora
AU - Raveh, Eyal
PY - 2012/10
Y1 - 2012/10
N2 - Background/Purpose: Lymphatic malformation is a benign disfiguring lesion of the neck and face in children. This study investigated the application and outcome of different modes of treatment. Methods: The medical files of all children with lymphatic malformation of the head and neck attending a tertiary medical center in 1999 to 2010 were reviewed. Findings were compared by treatment: surgery, OK-432 sclerotherapy, or observation. Results: The study group included 46 patients, most (65%) with macrocystic disease. Twenty were treated by OK-432 sclerotherapy, and 15, by surgery; 11 (with minor disfigurement) were observed only. Mean follow-up time was 2.4 years. Complete removal or complete response to treatment was achieved in 67% of the surgery group and 45% of the OK-432 group; fair results (> 50% reduction in swelling) were achieved in 20% and 50%, respectively. Sclerotherapy failure did not interfere with subsequent surgery. Complete spontaneous regression occurred in 5 patients under observation only. Conclusions: OK-432 sclerotherapy is associated with good aesthetic results in children with lymphatic malformation. Observation alone is sometimes sufficient. Surgery should be reserved for cases requiring a histologic diagnosis, microcystic disease, patients with an urgent clinical problem (eg, airway obstruction), and sclerotherapy failures.
AB - Background/Purpose: Lymphatic malformation is a benign disfiguring lesion of the neck and face in children. This study investigated the application and outcome of different modes of treatment. Methods: The medical files of all children with lymphatic malformation of the head and neck attending a tertiary medical center in 1999 to 2010 were reviewed. Findings were compared by treatment: surgery, OK-432 sclerotherapy, or observation. Results: The study group included 46 patients, most (65%) with macrocystic disease. Twenty were treated by OK-432 sclerotherapy, and 15, by surgery; 11 (with minor disfigurement) were observed only. Mean follow-up time was 2.4 years. Complete removal or complete response to treatment was achieved in 67% of the surgery group and 45% of the OK-432 group; fair results (> 50% reduction in swelling) were achieved in 20% and 50%, respectively. Sclerotherapy failure did not interfere with subsequent surgery. Complete spontaneous regression occurred in 5 patients under observation only. Conclusions: OK-432 sclerotherapy is associated with good aesthetic results in children with lymphatic malformation. Observation alone is sometimes sufficient. Surgery should be reserved for cases requiring a histologic diagnosis, microcystic disease, patients with an urgent clinical problem (eg, airway obstruction), and sclerotherapy failures.
KW - Lymphatic malformation
KW - OK-432
KW - Observation
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84867553985&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2012.06.005
DO - 10.1016/j.jpedsurg.2012.06.005
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AN - SCOPUS:84867553985
SN - 0022-3468
VL - 47
SP - 1837
EP - 1842
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 10
ER -