Miloundja J, Manfoumbi Ngoma A B, Mba Ella R, Nguema Edzang B, N'Zouba L
Service d'ORL et de chirurgie cervicofaciale, hôpital d'instruction des armées Omar-Bongo-Ondimba, BP 20404, Libreville, Gabon.
Ann Otolaryngol Chir Cervicofac. 2007 Dec;124(6):277-84. doi: 10.1016/j.aorl.2007.03.006.
To review the etiopathogenesis, diagnosis, and the role of surgery in the management of childhood cystic cervicofacial lymphangioma in Gabon.
Our retrospective study concerned 16 cases of childhood cystic cervicofacial lymphangioma treated surgically between 1990 and 2004.
The sample included ten girls and six boys whose average age was 30.2 months. The cystic lymphangioma was seen at birth in seven cases. It was discovered before 2 years in eight cases and after 2 years in eight cases. Two of these latter eight cases were a recurrence after previous surgery. The tumor was localized in the cervical are in ten cases, the jugal area in three cases, one of which was extended to the parotidis, the submandibular area in two cases, and the lower labial area in one case. The surgical indication was based on the clinical examination in six cases and on imaging in ten cases. The resection was considered complete in 14 cases and incomplete in two cases. In two cases, the resection was difficult, because the lymphangioma adhered to the internal jugular vein and rolled the higher laryngeal nerve and the carotid junction. The early complications were lymphoedema associated with facial paralysis (one case) and respiratory distress (one case), hematoma associated with facial paralysis (one case), lymphorrhea (one case), and a paralysis of the chin branch of the facial nerve (one case). The functional and aesthetic after-effects were marked by the persistence of facial paralysis and the existence of jugal bud flesh. The jugal (one case) and labial (one case) recurrence were discovered within 6 and 9 months after the surgery. In these two cases, there were capillary lymphangiomas. None of the patients died.
Cystic cervicofacial lymphangioma is a particular aspect of surgical pathology in children in Africa. Despite the advent of sclerosing products, surgery remains the treatment of choice in this context.
回顾加蓬儿童颈部囊性淋巴管瘤的病因发病机制、诊断及手术在其治疗中的作用。
我们的回顾性研究涉及1990年至2004年间接受手术治疗的16例儿童颈部囊性淋巴管瘤病例。
样本包括10名女孩和6名男孩，平均年龄为30.2个月。7例在出生时即发现囊性淋巴管瘤。8例在2岁前发现，8例在2岁后发现。后8例中有2例为先前手术后复发。肿瘤位于颈部10例，颊部3例，其中1例扩展至腮腺，颌下区2例，下唇区1例。手术指征6例基于临床检查，10例基于影像学检查。14例切除被认为完整，2例不完整。2例手术困难，因为淋巴管瘤与颈内静脉粘连，并累及喉上神经和颈动脉交界处。早期并发症包括与面瘫相关的淋巴水肿（1例）和呼吸窘迫（1例）、与面瘫相关的血肿（1例）、淋巴漏（1例）以及面神经下颌缘支麻痹（1例）。功能和美学后遗症表现为面瘫持续存在和颊部赘肉。颊部（1例）和唇部（1例）复发分别在术后6个月和9个月发现。这2例均为毛细淋巴管瘤。无患者死亡。
颈部囊性淋巴管瘤是非洲儿童外科病理学的一个特殊方面。尽管有硬化剂产品出现，但在此情况下手术仍是首选治疗方法。
