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头颈部淋巴管畸形的管理

Management for lymphatic malformations of head and neck.

作者信息

Yang Weijia, Wang Huaijie, Xie Chong, Lin Weilong, Wang Peihua, Guo Zhengtuan

机构信息

Department of Pediatric Surgery and Vascular Anomalies, Xi'an International Medical Center Hospital, Xi'an, China.

出版信息

Front Neurol. 2024 Oct 2;15:1450102. doi: 10.3389/fneur.2024.1450102. eCollection 2024.

DOI:10.3389/fneur.2024.1450102
PMID:39421571
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11483355/
Abstract

BACKGROUND

To explore the management of lymphatic malformation in head and neck.

METHODS

This is a retrospective study at a single center. Data on demographic, surgery, sclerotherapy and follow-up information were collected from our Vascular Anomalies Center database. Patients with lymphatic malformation of head and neck who had undergone surgery and sclerotherapy between March 2020 and March 2024 were included.

RESULTS

There were 94 patients in this study, the lesion sites included head ( = 60), tongue ( = 7), neck ( = 41), pharynx ( = 7), and head and neck ( = 7). Symptoms included bleeding ( = 6), infection ( = 2), dyspnea ( = 2), dysphonia ( = 4), and dysphagia ( = 4). Lymphatic malformation included macrocystic ( = 61), microcystic ( = 12) and mixed ( = 21). Surgeries for LM included radical resection, subtotal or partial resection and staged surgeries. Sclerotherapies included bleomycin monotherapy and combined sclerotherapy with ethanol and bleomycin, under ultrasound or fluoroscopy guidance. The follow-up period was from 3 months to 1 year. The therapeutic effect was evaluated according to the size of the treatment area. 55 patients, 21 patients, 11 patients and 7 patients were evaluated with excellent, good, moderate and no response, respectively.

CONCLUSION

Surgical resection, sclerotherapy and the combination of the two are efficacious treatment modalities for head and neck LM. Combined with oral drugs and other new therapies may be warranted in future for challenging conditions.

摘要

背景

探讨头颈部淋巴管畸形的治疗方法。

方法

这是一项单中心回顾性研究。从我们的血管畸形中心数据库收集了人口统计学、手术、硬化治疗和随访信息的数据。纳入2020年3月至2024年3月期间接受过手术和硬化治疗的头颈部淋巴管畸形患者。

结果

本研究共94例患者,病变部位包括头部(n = 60)、舌部(n = 7)、颈部(n = 41)、咽部(n = 7)以及头颈部(n = 7)。症状包括出血(n = 6)、感染(n = 2)、呼吸困难(n = 2)、声音嘶哑(n = 4)和吞咽困难(n = 4)。淋巴管畸形包括大囊型(n = 61)、微囊型(n = 12)和混合型(n = 21)。淋巴管畸形的手术包括根治性切除、次全或部分切除以及分期手术。硬化治疗包括博来霉素单一疗法以及在超声或透视引导下乙醇与博来霉素联合硬化治疗。随访期为3个月至1年。根据治疗区域的大小评估治疗效果。分别有55例、21例、11例和7例患者评估为优、良、中效和无效。

结论

手术切除、硬化治疗以及两者联合是治疗头颈部淋巴管畸形的有效方法。对于具有挑战性的病例,未来可能需要联合口服药物和其他新疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de52/11483355/33468f6a3b79/fneur-15-1450102-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de52/11483355/a51cad20deba/fneur-15-1450102-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de52/11483355/972f0e92206a/fneur-15-1450102-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de52/11483355/33468f6a3b79/fneur-15-1450102-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de52/11483355/a51cad20deba/fneur-15-1450102-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de52/11483355/972f0e92206a/fneur-15-1450102-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de52/11483355/33468f6a3b79/fneur-15-1450102-g003.jpg

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Curettage and sclerotherapy technique: A hybrid approach to superficial lymphatic malformation.刮除术联合硬化疗法:一种治疗表浅淋巴管畸形的混合方法。
Pediatr Dermatol. 2023 Mar;40(2):265-269. doi: 10.1111/pde.15202. Epub 2022 Nov 29.
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Liposuction-Like Sclerotherapy Technique for Microcystic Lymphatic Malformation.微囊性淋巴管畸形的抽脂样硬化治疗技术
Cureus. 2022 Mar 3;14(3):e22795. doi: 10.7759/cureus.22795. eCollection 2022 Mar.
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Lymphatic malformations.淋巴管畸形。
Semin Pediatr Surg. 2020 Oct;29(5):150971. doi: 10.1016/j.sempedsurg.2020.150971. Epub 2020 Sep 16.
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Vascular Anomalies: Diagnosis of Complicated Anomalies and New Medical Treatment Options.血管异常:复杂异常的诊断和新的医疗治疗选择。
Hematol Oncol Clin North Am. 2019 Jun;33(3):455-470. doi: 10.1016/j.hoc.2019.01.011.
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Sirolimus is efficacious in treatment for extensive and/or complex slow-flow vascular malformations: a monocentric prospective phase II study.西罗莫司治疗广泛和/或复杂慢血流血管畸形有效:单中心前瞻性 II 期研究。
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