de Serres L M, Sie K C, Richardson M A
Department of Otolaryngology-Head and Neck Surgery, Children's Hospital and Medical Center, Seattle, USA.
Arch Otolaryngol Head Neck Surg. 1995 May;121(5):577-82. doi: 10.1001/archotol.1995.01890050065012.
To propose a staging system for patients with lymphatic malformations of the head and neck.
Retrospective chart review.
Fifty-six patients were treated for lymphatic malformations from 1983 to 1993 at Children's Hospital and Medical Center, Seattle, Wash. The charts were reviewed for anatomic location of the lesion, preoperative and postoperative complications, number of procedures to control disease, long-term sequelae, and persistence of disease. Lesions were characterized as being unilateral or bilateral and suprahyoid and/or infrahyoid. The five patient groups were then compared with respect to the above categories.
Preoperative complications reviewed include preoperative infection, respiratory embarrassment necessitating airway intervention, and feeding difficulties. Postoperative complications assessed were cranial nerve injury, wound infection, and seroma formation. Long-term sequelae included malocclusion, speech delay, and cosmetic deformity. The rate of persistent disease was also assessed. A staging system was developed based on a progression of extent of disease. Stage I patients (n = 12) had unilateral infrahyoid disease and a 17% incidence of complications overall. Stage II patients (n = 17) had unilateral suprahyoid disease and a 41% incidence of complications. Stage III patients (n = 15) had unilateral suprahyoid and infrahyoid disease and a complication rate of 67%. Stage IV patients (n = 5) with bilateral suprahyoid disease had a complication rate of 80%, while stage V patients (n = 6) with bilateral suprahyoid and infrahyoid disease had a 100% incidence of complications.
Anatomic location of lymphatic malformations of the head and neck can be used to predict prognosis and outcome of surgical intervention.
提出一种针对头颈部淋巴管畸形患者的分期系统。
回顾性病历审查。
1983年至1993年期间，华盛顿州西雅图市儿童医院及医疗中心有56例患者接受了淋巴管畸形治疗。对病历进行审查，以了解病变的解剖位置、术前和术后并发症、控制疾病所需的手术次数、长期后遗症以及疾病的持续情况。病变被分为单侧或双侧，以及舌骨上和/或舌骨下。然后对这五组患者在上述类别方面进行比较。
审查的术前并发症包括术前感染、需要气道干预的呼吸窘迫以及喂养困难。评估的术后并发症有脑神经损伤、伤口感染和血清肿形成。长期后遗症包括咬合不正、言语延迟和美容畸形。还评估了疾病持续率。基于疾病范围的进展制定了一个分期系统。I期患者（n = 12）有单侧舌骨下疾病，总体并发症发生率为17%。II期患者（n = 17）有单侧舌骨上疾病，并发症发生率为41%。III期患者（n = 15）有单侧舌骨上和舌骨下疾病，并发症发生率为67%。IV期患者（n = 5）有双侧舌骨上疾病，并发症发生率为80%，而V期患者（n = 6）有双侧舌骨上和舌骨下疾病，并发症发生率为100%。
头颈部淋巴管畸形的解剖位置可用于预测手术干预的预后和结果。
