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Pediatric lymphangiomas of the head and neck
1Department of Otorhinolaryngology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Insights
This study analyzed pediatric head and neck lymphangiomas, finding common locations and treatment variations. Certain lesion sites were linked to higher recurrence rates, suggesting a need for a refined staging system.
Area of Science:
- Pediatric Surgery
- Head and Neck Surgery
- Vascular Malformations
Background:
- Lymphangiomas are congenital vascular malformations.
- Head and neck lymphangiomas present unique diagnostic and management challenges in children.
Purpose of the Study:
- To define the cause, presentation, diagnosis, and staging of pediatric head and neck lymphangiomas.
- To review institutional experience with these lesions and propose a novel staging system.
Main Methods:
- Retrospective review of 67 pediatric head and neck lymphangioma cases from 1986-1996.
- Analysis of patient demographics, clinical presentation, location, treatment modalities, and outcomes.
- Development of a staging system based on functional deficit, cosmetic changes, site, and age.
Main Results:
- Most patients (67) presented with a mass; 5 required tracheotomy for airway obstruction.
- Common locations included the submandibular region (37%) and parotid gland (31%).
- Lesions in the lip, hypopharynx/larynx, tongue, and floor of mouth showed high recurrence rates.
Conclusions:
- Pediatric head and neck lymphangiomas require tailored management based on location and severity.
- A proposed staging system aims to better stratify risk and guide treatment for these complex lesions.
- Further research is needed to validate the proposed staging system.
Abstract:
To better define the cause, presentation, diagnosis, and staging of lymphangiomas, we reviewed all cases of lymphangiomas of the head and neck region in children seen at our institution between 1986 and 1996. Sixty-seven children were identified (31 male and 36 female). Age at presentation ranged from birth to 18 years. All but 8 patients presented with an obvious mass, and 5 required tracheotomy because of airway obstruction. The most common location was the submandibular region (37%), followed by the parotid gland (31%). Treatment ranged from observation to extensive and multiple resections. Thirty-one patients underwent only 1 resection, and 2 patients received interferon as part of their treatment. Lesions involving the lip, hypopharynx and/or larynx, the tongue, and the floor of the mouth had high rates of recurrent or persistent disease. We review our experience with these difficult lesions and propose a staging system based on functional deficit, cosmetic changes, sites of involvement, and age at diagnosis.