Surgical excision of cervicofacial giant macrocystic lymphatic malformations in infants and children.

OBJECTIVES

Various modalities have been used to treat lymphatic malformations, such as steroids, the injection of sclerosing agents, aspiration, and surgery. Giant macrocystic lymphangiomas involving the cervicofacial region in infants and children constitute a major therapeutic challenge.

METHODS

This was a retrospective review of 47 pediatric patients with giant macrocystic lymphatic malformations of the cervicofacial region that underwent surgical resections. There were 27 males and 20 females; 25 were newborns, 9 were infants, 8 were of preschool age, and 5 were school age. Of the patients, 72.4% was presented before 3 years of age. The neck was involved in 48.9% of the patients, followed by the parotid region and parapharynx (34.0%), lingual base and oral floor (12.8%), and face and cheek (4.3%). The lesions ranged from 4 x 3 to 15 x 10 cm in size. All cases showed symptoms of space-occupying lesions preoperatively.

RESULTS

Hemorrhage within the lessons was the most common preoperative symptom, and dysphasia and airway obstruction are serious preoperative symptoms. Nine (19.1%) minor surgical complications occurred. The mean follow-up was 9.6 months; five patients had recurrent lesions, while surgical radicality was achieved in 89.4% of the cases. A significantly higher rate of residual or recurrent lesions was noted in the newborn group, as compared with the other age groups (P=0.04; chi(2) test).

CONCLUSIONS

Surgical dissection of giant macrocystic lymphatic malformations involving the cervicofacial region in infants and children is safe and gives satisfactory esthetic and functional results, including lesions in the newborn.