Low power radiofrequency ablation for symptomatic microcystic lymphatic malformation of the tongue

Although many head and neck surgeons agree that complete surgical excision is the treatment of choice for lymphatic malformation, the infiltrating nature of microcystic lymphatic malformations and the involvement of vital structures of the head and neck make total removal nearly impossible in most cases. Recently radiofrequency ablation was introduced for the treatment of microcystic lymphatic malformations of the oral cavity; it destroys lesion tissues at low temperature (40-70 degrees C) with minimal damage to adjacent structures. However, high energy (800-1200 J) and general anesthesia for radiofrequency ablation can hinder the easy and repetitive application of radiofrequency to patients. To overcome this limitation of radiofrequency ablation for microcystic lymphatic malformations, we used the same technique with a lower power (6 W, less than 100 J per site) radiofrequency ablation in an office-based setting under local anesthesia in a child with a microcystic lymphatic malformation of the whole tongue, that was associated with recurrent bleeding and swelling. The repetitive low power energy radiofrequency ablation of the microcystic lymphatic malformation of the tongue was safe and effective; it provided the patient with symptomatic relief without recurrence at follow-up. Therefore, our modification of radiofrequency ablation of the microcystic lymphatic malformations could be technically feasible and easily applicable; our result suggests that it can be a useful alternative treatment option to relieve symptoms from microcystic lymphatic malformation of the oral cavity.