Lille S T, Rand R P, Tapper D, Gruss J S
Department of Surgery, University of Washington School of Medicine, Seattle 98195-6410, USA.
J Pediatr Surg. 1996 Dec;31(12):1648-50. doi: 10.1016/s0022-3468(96)90039-1.
Giant cervicofacial lymphatic malformation, a potentially life-threatening congenital malformation, historically has been removed in staged resections. However, complete surgical extirpation is desirable and can be achieved with the aid of a multidisciplinary team. The authors present the case of a 12-year-old girl who had an extensively enlarged cervicofacial lymphatic malformation. Effective treatment involved aggressive surgical excision, facilitated by mandibular osteotomies to provide access to the floor of the mouth, the tongue, and the pharyngeal wall. In addition, total removal of involved facial and neck skin was performed. The remaining soft tissue defect was reconstructed primarily with an abdominal musculocutaneous free flap. In the 5 years since the procedure, there has been no recurrence. Based on this experience, excision of involved skin and mandibular access osteotomies are important techniques to help completely remove cervicofacial lymphatic malformations with oral involvement, thus potentially reducing the number of recurrences. In addition, these cases require the best efforts of a multidisciplinary team to achieve a successful result so that complete and radical excision can be performed with the hope of avoiding the pitfalls of multiple resections.
巨大颈面部淋巴管瘤是一种潜在危及生命的先天性畸形，以往一直采用分期切除。然而，理想的是进行完整的手术切除，并且借助多学科团队能够实现这一目标。作者报告了一例12岁女孩患有广泛肿大的颈面部淋巴管瘤的病例。有效的治疗包括积极的手术切除，通过下颌骨截骨术辅助以显露口底、舌和咽壁。此外，还对受累的面部和颈部皮肤进行了彻底切除。剩余的软组织缺损主要采用腹部游离肌皮瓣进行修复。术后5年未见复发。基于这一经验，切除受累皮肤和下颌骨截骨术是帮助完全切除累及口腔的颈面部淋巴管瘤的重要技术，从而有可能减少复发次数。此外，这些病例需要多学科团队的全力协作以取得成功结果，以便能够进行完整和彻底的切除，有望避免多次切除的弊端。
