Parashar Gaurav, Shankar Gowri, Sahadev Ravindra, Santhanakrishnan Ramesh
Department of Pediatric Surgery, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
J Indian Assoc Pediatr Surg. 2020 Mar-Apr;25(2):80-84. doi: 10.4103/jiaps.JIAPS_2_19. Epub 2020 Jan 28.
The management of lymphatic malformations (LMs) continues to improve with advancement in molecular genetics, imaging, and treatment options. However, the management of tongue LMs remains a challenge due to the location, function involved, and long-term disabilities. We propose injection sclerotherapy with bleomycin in the management of spectrum of tongue LMs.
Children with LMs involving the tongue were prospectively treated with bleomycin sclerotherapy. Outcome measured was the efficacy of sclerotherapy, complications, and functional outcome.
A total of 11 children underwent sclerotherapy with bleomycin for varying tongue lesions. Excellent outcome was seen in children with macroglossia. Eight children with isolated (focal) lesions had a resolution of symptoms with a clearance of lesions. Specific complications related to bleomycin toxicity were not encountered in our series during the follow-up of 4 years.
In our series, children with macroglossia had an excellent outcome with normalization of tongue size and function. Children with focal tongue lesions also had good to excellent outcome. We recommend treatment of tongue LM with bleomycin sclerotherapy as the first line of management. Ease of treatment, early intervention, and excellent response makes it a favorable treatment option.
随着分子遗传学、影像学及治疗方法的不断进步，淋巴管畸形（LMs）的治疗持续改善。然而，由于舌部淋巴管畸形的位置、所涉及的功能以及长期致残问题，其治疗仍然是一项挑战。我们提出使用博来霉素进行注射硬化治疗以处理各种舌部淋巴管畸形。
对累及舌部的淋巴管畸形患儿进行前瞻性博来霉素硬化治疗。测量的结果包括硬化治疗的疗效、并发症及功能结局。
共有11名儿童因不同的舌部病变接受了博来霉素硬化治疗。巨舌症患儿治疗效果极佳。8名孤立（局灶性）病变患儿症状消退，病变清除。在我们的系列研究中，随访4年期间未出现与博来霉素毒性相关的特定并发症。
在我们的系列研究中，巨舌症患儿舌部大小及功能恢复正常，治疗效果极佳。局灶性舌部病变患儿的治疗效果也良好至极佳。我们建议将博来霉素硬化治疗作为舌部淋巴管畸形治疗的一线方案。治疗简便、可早期干预且反应良好，使其成为一种理想的治疗选择。
