Lerat J, Bisdorff-Bresson A, Borsic M, Chopinet C, Couloignier V, Fakhry N, Fayoux P, Jegoux F, Larralde A, Leboulanger N, Nicollas R, Letourmy S Pondaven
Service ORL et chirurgie cervico-faciale, hôpital Mère-Enfant, CHU de Limoges, 87042 Limoges, France.
Service neuroradiologie interventionnelle, hôpital Lariboisière, AP-HP, 75010 Paris, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Apr;136(2):109-112. doi: 10.1016/j.anorl.2019.02.005. Epub 2019 Feb 25.
The authors present the guidelines of the French Society of Otorhinolaryngology (SFORL) for the diagnosis of cervical lymphatic malformation in adults and children.
A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group, and finalized in a coordination meeting. Guidelines were graded A, B, C or expert opinion, by decreasing level of evidence.
The SFORL recommends that complete ENT examination should be performed to identify lesions at high risk of complication or associated with poor prognosis. In case of diagnostic doubt, especially in latero-cervical or oral floor lesions, fine-needle aspiration cytology should be performed before therapeutic decision-making. One or more validated classifications should be used to assess treatment efficacy and monitor progression. The reliability of antenatal diagnosis should be ensured by associating MRI to ultrasound. In antenatal diagnosis, the locoregional extension of the cervical lymphatic malformation should be evaluated accurately for prognosis, and associated malformations should be screened for, to guide treatment options.
作者介绍了法国耳鼻咽喉科学会(SFORL)关于成人和儿童颈部淋巴管畸形诊断的指南。
委托一个多学科工作小组对上述主题的科学文献进行综述。根据检索到的文章和小组成员的个人经验制定指南。然后由一个独立于工作小组的编辑小组审阅,并在一次协调会议上最终确定。根据证据水平的降低,指南分为A、B、C级或专家意见。
SFORL建议应进行全面的耳鼻喉科检查,以识别有并发症高风险或预后不良的病变。在诊断存疑时,尤其是对于颈外侧或口底病变,在做出治疗决策前应进行细针穿刺细胞学检查。应使用一种或多种经过验证的分类方法来评估治疗效果并监测病情进展。产前诊断的可靠性应通过将MRI与超声相结合来确保。在产前诊断中,应准确评估颈部淋巴管畸形的局部区域扩展情况以判断预后,并筛查相关畸形,以指导治疗方案的选择。