Talmor Guy, Nguyen Brandon, Mir Ghayoour, Badash Ido, Kaye Rachel, Caloway Christen
Department of Otolaryngology-Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA.
Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California, USA.
Otolaryngol Head Neck Surg. 2021 Dec;165(6):775-783. doi: 10.1177/01945998211000448. Epub 2021 Mar 23.
The role of sclerotherapy for vascular lesions of the head and neck is well established. However, the efficacy of sclerotherapy for benign cystic lesions of the head and neck is less clear. The objective of this review is to determine the efficacy and safety of sclerotherapy for benign cystic lesions of the head and neck.
PubMed/MEDLINE, Cochrane Library, and Embase.
The PRISMA guidelines (Preferred Reporting Systems for Systematic Reviews and Meta-analyses) were followed for this systematic review. Studies of patients with benign head and neck cystic masses treated primarily with sclerotherapy were included. Thirty-two studies met criteria for inclusion.
A total of 474 cases of sclerotherapy were reviewed. Agents comprised OK-432, ethanol, doxycycline, tetracycline, and bleomycin. Lesions in the analysis were ranula, thyroglossal duct cyst, branchial cleft cyst, benign lymphoepithelial cyst, parotid cyst, thoracic duct cyst, and unspecified lateral neck cyst. A total of 287 patients (60.5%) had a complete response; 132 (27.9%) had a partial response; and 55 (11.6%) had no response. OK-432 was the most widely utilized agent, with a higher rate of complete response than that of ethanol (62.0% vs 39.4%, = .015). Fifty-three cases (11.2%) required further surgical management. One case of laryngeal edema was reported and managed nonoperatively.
Sclerotherapy appears to be a safe and efficacious option for benign cystic lesions if malignancy is reliably excluded. Efficacy rates are comparable to those of sclerotherapy for vascular malformations. The rate of serious complications is low, with 1 incident of airway edema reported in the literature.
硬化疗法对头颈部血管病变的作用已得到充分证实。然而，硬化疗法对头颈部良性囊性病变的疗效尚不太明确。本综述的目的是确定硬化疗法对头颈部良性囊性病变的疗效和安全性。
PubMed/MEDLINE、Cochrane图书馆和Embase。
本系统综述遵循PRISMA指南（系统评价和Meta分析的首选报告系统）。纳入主要采用硬化疗法治疗的头颈部良性囊性肿物患者的研究。32项研究符合纳入标准。
共回顾了474例硬化疗法病例。所用药物包括OK-432、乙醇、强力霉素、四环素和博来霉素。分析中的病变包括舌下囊肿、甲状舌管囊肿、鳃裂囊肿、良性淋巴上皮囊肿、腮腺囊肿、胸导管囊肿和未明确的侧颈部囊肿。共有287例患者（60.5%）完全缓解；132例（27.9%）部分缓解；55例（11.6%）无反应。OK-432是使用最广泛的药物，其完全缓解率高于乙醇（62.0%对39.4%，P = 0.015）。53例（11.2%）需要进一步手术治疗。报告了1例喉水肿并经非手术处理。
如果能可靠排除恶性肿瘤，硬化疗法似乎是治疗良性囊性病变的一种安全有效的选择。其有效率与硬化疗法治疗血管畸形的有效率相当。严重并发症发生率低，文献中仅报告了1例气道水肿事件。
