Shum Axel, Beydoun Ahmed Sam, Khalifee Elie, Carlberg Valerie, Plunk Matthew, Chun Robert
Medical College of Wisconsin, Department of Otolaryngology, Milwaukee, WI, USA.
Medical College of Wisconsin, Department of Otolaryngology, Milwaukee, WI, USA; Children's Wisconsin, Department of Otolaryngology/Medical College of Wisconsin, Milwaukee, WI, USA.
Int J Pediatr Otorhinolaryngol. 2023 May;168:111510. doi: 10.1016/j.ijporl.2023.111510. Epub 2023 Mar 15.
Lymphatic malformations in the submandibular neck pose unique challenges to treatment that elevate their risk of recurrence. This case series provides a review of five patients, previously treated with sclerotherapy or with a history of multiple infections, who were treated in a novel fashion: single-stage resection using preoperative n-butyl cyanoacrylate (n-BCA) glue embolization.
We performed a retrospective medical record review of five patients who underwent single-stage n-BCA embolization by Interventional Radiology followed by surgical resection by Otolaryngology, including a review of their symptoms, previous treatments, and post-treatment surveillance, with follow-up ranging from 4 to 24 months after the treatment of interest.
All study subjects had unremarkable perioperative courses, and four patients did not demonstrate any evidence of disease recurrence or persistence during the follow-up period. One patient was found to have a small area of persistent disease on post-treatment imaging, but has remained symptom free.
Treatment of submandibular lymphatic malformations with n-BCA embolization followed by surgical resection can be performed in a single stage. This case series demonstrates that this approach can yield durable relief of symptoms, even in patients whose lesions were refractory to previous treatments.
下颌下颈部的淋巴管畸形给治疗带来了独特的挑战，增加了复发风险。本病例系列回顾了五例患者，这些患者之前接受过硬化治疗或有多次感染史，此次采用了一种新的治疗方式：术前使用正丁基氰基丙烯酸酯（n-BCA）胶水栓塞进行一期切除。
我们对五例患者进行了回顾性病历审查，这些患者接受了介入放射科的一期n-BCA栓塞，随后由耳鼻喉科进行手术切除，审查内容包括他们的症状、既往治疗情况以及治疗后的监测，随访时间为感兴趣的治疗后4至24个月。
所有研究对象的围手术期过程均无异常，四名患者在随访期间未出现任何疾病复发或持续存在的证据。一名患者在治疗后的影像学检查中发现有一小片持续性病变，但一直无症状。
采用n-BCA栓塞后手术切除的方法可对下颌下淋巴管畸形进行一期治疗。本病例系列表明，即使是对先前治疗无效的病变患者，这种方法也能持久缓解症状。
