Considerations for Management of Head and Neck Lymphatic Malformations in Children.

Published

Journal Article

OBJECTIVE: There exist inherent problems with previously described classification schemes for head and neck lymphatic malformations in children and lack of guidance for management. An organization scheme and management recommendations are proposed to improve communication between health care providers. STUDY DESIGN: Consecutive patient series with a chart review of children with head and neck lymphatic malformations. SETTING: Tertiary-care, academic children's hospital. METHODS: Children with lymphatic malformations of the head and neck were included. A proposed organization system for head and neck lymphatic malformations in children was developed and compared to 2 others currently predominantly used, de Serres and Cologne Disease Score. RESULTS: Seventeen patients were identified, 7 boys and 10 girls. The mean age was 64.4 months (range 0.89-185.5). Nine patients (52.9%) were managed expectantly, 5 (29.4%) with sclerotherapy with 1 awaiting treatment (5.9%), and 2 (11.8%) with surgical excision. All children who underwent active treatment with surgery or sclerotherapy were managed successfully. No treatment-related complications were encountered, and no children managed with watchful waiting/expectant management experienced failure. The proposed staging system differed from the de Serres stage in 11 children (64.7%), with 9 (81.8%) being down staged and 2 (18.2%) up staged. Cologne Disease Score ranged from 2 to 10, with only 1 (5.9%) patient with a score of 3 or less (severe disease). CONCLUSIONS: Treatment recommendations in children with head and neck lymphatic malformations should be individualized. Weaknesses of currently used staging systems are discussed as well as considerations for management decisions.

Full Text

Duke Authors

Cited Authors

  • Cheng, J; Bastidas, N

Published Date

  • June 2016

Published In

Volume / Issue

  • 27 / 4

Start / End Page

  • 908 - 912

PubMed ID

  • 27192651

Pubmed Central ID

  • 27192651

Electronic International Standard Serial Number (EISSN)

  • 1536-3732

Digital Object Identifier (DOI)

  • 10.1097/SCS.0000000000002621

Language

  • eng

Conference Location

  • United States