Safety and efficacy of surgery combined with bleomycin irrigation for complex cervical-facial lymphatic malformations of children

Int J Pediatr Otorhinolaryngol. 2020 Jan:128:109724. doi: 10.1016/j.ijporl.2019.109724. Epub 2019 Oct 12.

Abstract

Background: In this retrospective study, we compare the safety and efficacy of surgery combined with bleomycin intra-operatively with intralesional sclerotherapy alone for the management of head and neck lymphatic malformations in children.

Materials and methods: The patients with cervical-facial lymphatic malformations were reviewed in Shanghai Children's Hospital from August 2014 to August 2018. Data analysis was performed using SPSS17.0. Pearson X2 test and t-test were used, and the significance level was fixed at 5%.

Results: 72 patients in all of which 63 patients underwent surgical excision combined with bleomycin irrigation and 9 patients underwent sclerotherapy alone as the primary treatment. The surgical excision group had a significantly higher rate of an excellent response compare to the sclerotherapy group (P < 0.05). In regards to postoperative complications, the surgical group had no higher rate of temporal facial paralysis and other nerve injures compare to the sclerotherapy group (P = 0.624).

Conclusions: we recommend surgery combined with Bleomycin for microcystic disease with focal and less infiltrative lesions and for lesions located in the oropharynx, parapharynx, retropharynx, or hypopharynx.

Keywords: Bleomycin; Cervical-facial; Lymphatic malformation; Operation; Sclerotherapy.

MeSH terms

  • Adolescent
  • Bleomycin / administration & dosage*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Craniofacial Abnormalities / therapy*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intraoperative Care
  • Lymphatic Abnormalities / therapy*
  • Male
  • Postoperative Complications
  • Retrospective Studies
  • Sclerosing Solutions / administration & dosage*
  • Sclerotherapy*
  • Therapeutic Irrigation*

Substances

  • Sclerosing Solutions
  • Bleomycin