Benazzou Salma, Boulaadas Malik, Essakalli Leila
Department of Maxillofacial Surgery and ENT, Avicenne University Medical Center, Rabat, Morocco.
J Craniofac Surg. 2013 Jul;24(4):1307-9. doi: 10.1097/SCS.0b013e3182942b8f.
Lymphatic malformations (LMs) are benign lesions. Most of them are found in head and neck regions as asymptomatic mass, but giant lymphangiomas may affect breathing or swallowing and constitute a major therapeutic challenge.
A retrospective analysis of giant head and neck LMs with impairment of respiration or swallow for the past 11 years was performed in the Department of Maxillofacial Surgery and ENT of the Avicenne Medical University Center.
Seven patients with large and extensive LMs of the head and neck were identified. There were 3 males and 4 females with a mean age of 6 years. The predominant reason for referral was airway compromise necessitating tracheostomy (57%) and dysphagia (43%). Three patients had macrocystic lesions; others were considered mixed or microcystic. All the patients underwent surgical excision as a primary treatment modality. Complete surgical resection was realized in 4 patients, and subtotal resection in 3 patients. Of 7 patients, 4 patients had complications including nerve damage and recurrence of the disease. The majority of the patients underwent only a single surgical procedure.
Cervicofacial LMs in children should be managed in multidisciplinary setting. Surgery remains the first treatment for managing giant, life-threatening lesions.
淋巴管畸形（LMs）是良性病变。它们大多在头颈部被发现，表现为无症状肿块，但巨大淋巴管瘤可能影响呼吸或吞咽，构成重大治疗挑战。
对阿维森纳医学大学中心颌面外科和耳鼻喉科过去11年中出现呼吸或吞咽障碍的巨大头颈部LMs进行回顾性分析。
确定了7例头颈部巨大且广泛的LMs患者。其中男性3例，女性4例，平均年龄6岁。转诊的主要原因是气道受压需要气管切开术（57%）和吞咽困难（43%）。3例患者有大囊型病变；其他患者被认为是混合型或微囊型。所有患者均接受手术切除作为主要治疗方式。4例患者实现了完全手术切除，3例患者进行了次全切除。7例患者中有4例出现并发症，包括神经损伤和疾病复发。大多数患者仅接受了一次外科手术。
儿童颈面部LMs应在多学科环境中进行管理。手术仍然是治疗巨大的、危及生命的病变的首选方法。
