CHOICE OF TREATMENT OPTIONS FOR CYSTIC LYMPHATIC MALFORMATIONS IN THE HEAD AND NECK REGION: TREATMENT EXPERIENCE OF 81 CHILDREN
DOI:
https://doi.org/10.11603/2415-8798.2017.4.8373Keywords:
hemangioma, vascular malformations, newborn.Abstract
Vascular anomalies in the neonatal period are diagnostic and therapeutic challenge for the lack evident signs, symptoms and follow-up, and the use of invasive diagnostic tests is limited.
The aim of the study – retrospective analysis of cases of vascular anomalies in newborns, establishing their main symptoms and indications for urgent treatment.
Materials and Methods. All cases of vascular anomaly presented to our unit before 28 days of age between 2011 and 2017 were reviewed. Clinical complications and emergency treatment modality were established.
Results and Discussion. Among 238 children with vascular anomalies, clinical manifestations were detected in up to 28 days of life in 137 (57.56 %), and the need for treatment arose in 7 (2.94 %) cases. The indications for treatment were compression of the upper airway in children with the head and neck lymphatic malformations (n=4), hepatic, cardiovascular failure in children with infantile hemangiomas of the liver (n=3), thrombocytopenia in children with kaposiform hemangioendothelioma (n=3). The following treatments options were used: resection of malformation, tracheostomy, sclerotherapy (n=4), conservative therapy with propranolol (n=3) and corticosteroids (n=3).
Conclusions. These therapeutic tactics allowed stabilizihg the newborns with vascular abnormalities and providing for the possibility of further treatment. Newborn babies with uncomplicated vascular abnormalities without functional disorders did not received any treatment.
References
Elluru, R., Balakrishnan, K. & Padua, H. (2014). Lymphatic malformations: Diagnosis and management. Seminars in Pediatric Surgery, 23(4), 178-185.
Perkins, J., Manning, S., Tempero, R., Cunningham, M., Edmonds, J., Hoffer, F. & Egbert, M. (2010). Lymphatic malformations: Current cellular and clinical investigations. Otolaryngology-Head and Neck Surgery, 142 (6), 789-794.
Churchill, P., Otal, D., Pemberton, J., Ali, A., Flageole, H. & Walton, J.M. (2011). Sclerotherapy for lymphatic malformations in children: a scoping review. J of Pediatr Surg., (46), 912-922.
Chen, E., Hostikka, S., Oliaei, S., Duke, W., Schwartz, S. & Perkins, J. (2009). Similar Histologic Features and Immunohistochemical Staining in Microcystic and Macrocystic Lymphatic Malformations. Lymphatic Research and Biology, 7 (2), 75-80.
Ardıçlı, B., Karnak, İ., Çiftçi, A., Tanyel, F. & Şenocak, M. (2015). Sclerotherapy with bleomycin versus surgical excision for extracervical cystic lymphatic malformations in children. Surgery Today, 46(1), 97-101.
Weitz-Tuoretmaa, A., Rautio, R., Valkila, J., Keski-Säntti, H., Keski-Nisula, L. & Laranne, J. (2013). Efficacy of OK-432 sclerotherapy in treatment of lymphatic malformations: long-term follow-up results. European Archives of Oto-Rhino-Laryngology, 271 (2), 385-390.
Adams, M., Saltzman, B. & Perkins, J. (2012). Head and Neck Lymphatic Malformation Treatment. Otolaryngology-Head and Neck Surgery, 147 (4), 627-639.
Love, Z. & Hsu, D. (2011). Low-flow vascular malformations of the head and neck: clinicopathology and image guided therapy. Journal of NeuroInterventional Surgery, 4 (6), 414-425.
Malic, C., Guilfoyle, R., Courtemanche, R., Arneja, J., Heran, M. & Courtemanche, D. (2017). Lymphatic Malformation Architecture. Journal of Craniofacial Surgery, 28 (7), 1721-1724.
Acevedo, J., Shah, R. & Brietzke, S. (2008). Nonsurgical therapies for lymphangiomas: A systematic review. Otolaryngology-Head and Neck Surgery, 138(4), 418-424.
Horbach, S., Lokhorst, M., Saeed, P., de Goüyon Matignon de Pontouraude, C., Rothová, A. & van der Horst, C. (2016). Sclerotherapy for low-flow vascular malformations of the head and neck: A systematic review of sclerosing agents. Journal of Plastic, Reconstructive & Aesthetic Surgery, 69 (3), 295-304.
Wiegand S., Eivazi B., Sel S., Renz H., Werner J.A. & Folz B.J. (2008). Analysis of Cytokine Levels in Human Lymphangiomas. In vivo, 22. 253-256.
Ogita S., Tsuto T., Deguchi E., Tokiwa K., Nagashima M. & Iwai N. (1991). OK 432 therapy for unresectable lymphangiomas in children. J PedSurg., 26. 263-270.
Ghaffarpour, N., Petrini, B., Svensson, L., Boman, K., Wester, T. & Claesson, G. (2015). Patients with lymphatic malformations who receive the immunostimulant OK-432 experience excellent long-term outcomes. Acta Paediatrica, 104 (11), 1169-1173.
Tu, J., Do, H., Patel, V., Yeom, K. & Teng, J. (2016). Sclerotherapy for lymphatic malformations of the head and neck in the pediatric population. Journal of NeuroInterventional Surgery, 9 (10), 1023-1026.
Benzar, I. (2014). Treatment of Lymphatic malformations with OK-432: the First Experience of a Single Hospital International Journal of Biomedicine, 4 (4), 237-241.
Smith, M., Zimmerman, M., Burke, D., Bauman, N., Sato, Y. & Smith, R. (2009). Efficacy and safety of OK-432 immunotherapy of lymphatic malformations. The Laryngoscope, 119 (1), 107-115.
Ogita, S., Tsuto, T., Tokiwa, K. & Takahashi, T. (1987). Intracystic injection of OK-432: a new sclerosing therapy for cystic hygroma in children. Br J Surg., 74 (8), 690-691.
Ogita S., Tsuto, T., Nakamura, K., Deguchi, E. & Iwai, N. (1994) .OK-432 therapy in 64 patients with lymphangioma. J Pediatr Surg., 29 (6). 784-785.
Poldervaart, M., Breugem, C., Speleman, L. & Pasmans, S. (2009). Treatment of Lymphatic Malformations With OK-432 (Picibanil). Journal of Craniofacial Surgery, 20 (4), 1159-1162.
Trenor, C. & Chaudry, G. (2014). Complex lymphatic anomalies. Seminars in Pediatric Surgery, 23 (4), 186-190.
Kim, D. (2014). OK-432 sclerotherapy of lymphatic malformation in the head and neck: factors related to outcome. Pediatric Radiology, 44 (7), 857-862.
Downloads
Published
How to Cite
Issue
Section
License
Authors who sent their manuscript to "Вісник наукових досліджень. Bulletin of Scientific Research" Surgery agree to the following terms:
a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal. 
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
