Vancouver, British Columbia, Canada; and Dallas, Texas From the Division of Plastic Surgery, British Columbia Children's Hospital and University of British Columbia, and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
Plast Reconstr Surg. 2013 Mar;131(3):373e-379e. doi: 10.1097/PRS.0b013e31827c6fe2.
Lip hemangiomas have traditionally been approached with expectant management. However, intervention is warranted for associated complications, including facial disfigurement, feeding difficulties, speech impairment, and psychosocial manifestations. The authors evaluated outcomes of complicated lip hemangiomas resected during the proliferative as compared with the involutional phase.
A retrospective review of patients with complicated lip hemangiomas managed with resection in the proliferative or involutional phase from 2005 to 2011 was performed. A transverse elliptical vermilion-mucosal resection technique was used. Review parameters included demographics, lesion size and location, growth phase, hemangioma-related complications, and preoperative management (corticosteroid or pulsed dye laser). Evaluated outcomes included surgical complications, recurrence, and patient- and surgeon-reported aesthetics.
Twenty-one patients underwent surgical resection of a lip hemangioma (10 proliferative and 11 involutional), with a mean follow-up of 21.4 and 23.3 months, respectively. The two groups were comparable with respect to lesion size and location. Patients in the involutional group experienced higher rates of hemangioma-related complications (bleeding, 45 percent versus 10 percent; speech impairment, 82 percent versus 0 percent; feeding difficulties, 82 percent versus 20 percent; and psychosocial issues, 100 percent versus 80 percent). There were no postoperative aesthetic concerns. One recurrence in the proliferative group was treated with reresection. Speech therapy was required for 82 percent of patients in the involutional group.
Surgical resection is efficacious treatment for hemangiomas of the lip and yields acceptable aesthetic results during both the proliferative and involutional phases. Resection in the proliferative phase should be considered to prevent complications associated with delayed treatment.
传统上，唇部血管瘤采用保守治疗。然而，对于相关并发症，如面部畸形、喂养困难、言语障碍和心理社会表现，需要进行干预。作者评估了在增殖期和消退期切除复杂唇部血管瘤的结果。
回顾性分析了 2005 年至 2011 年间接受增殖期或消退期切除治疗的复杂唇部血管瘤患者的资料。采用横椭圆形唇红-黏膜切除术。回顾的参数包括人口统计学、病变大小和位置、生长阶段、血管瘤相关并发症以及术前管理（皮质类固醇或脉冲染料激光）。评估的结果包括手术并发症、复发以及患者和外科医生报告的美容效果。
21 例患者接受了唇部血管瘤切除术（增殖期 10 例，消退期 11 例），平均随访时间分别为 21.4 个月和 23.3 个月。两组在病变大小和位置方面具有可比性。消退组患者血管瘤相关并发症发生率较高（出血 45%比 10%；言语障碍 82%比 0%；喂养困难 82%比 20%；心理社会问题 100%比 80%）。术后无美学问题。增殖组 1 例复发患者再次接受了切除术。消退组 82%的患者需要接受言语治疗。
手术切除是唇部血管瘤的有效治疗方法，在增殖期和消退期均可获得可接受的美容效果。对于延迟治疗相关并发症，应考虑在增殖期进行切除。
