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Published on: December 22, 2023
Sclerotherapy with polidocanol microfoam in head and neck venous and lymphatic malformations
Eugenio De Corso1, Alessandro Cina2, Giampiero Salonna1
1UOC Otorinolaringoiatria, Area Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Objective:
Polidocanol sclerotherapy of head and neck venous malformations (VMs) and lymphatic malformations (LMs) has been reported only in limited series. In this manuscript we evaluated the efficacy and safety of polidocanol sclerotherapy in a series of head and neck venous and lymphatic malformations.
Methods:
This retrospective observational study analysed data on 20 head and neck VMs and LMs that underwent to percutaneous or endoscopic intra-lesional 3% polidocanol microfoam sclerotherapy at our institution. Clinical response was ranked as excellent, moderate and poor based on volume reduction by MRI and resolution of symptoms.
Results:
The median volume decreased from 19.3 mL to 5.8 mL after sclerotherapy (mean volume reduction: 72.98 ± 16.1%). An excellent-moderate response was observed in 94.4% of cases. We observed a mean volume reduction of 79.5 ± 16.1 in macrocystic LMs, of 76.1 ± 13.0% in VMs, of 60.5 ± 10.9% in mixed lymphatic ones and 42.5% in microcystic lymphatic ones.
Conclusions:
Polidocanol sclerotherapy appears to be an effective and safe treatment for venous and lymphatic head and neck malformations. We observed the best responses in macrocystic LMs and VMs, whereas mixed lymphatic ones showed a moderate response and microcystic lymphatic ones a poor response.
Insights
Polidocanol sclerotherapy effectively treats head and neck venous malformations (VMs) and lymphatic malformations (LMs). This safe treatment showed significant volume reduction, with best results in macrocystic LMs and VMs.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Dermatology
Background:
- Head and neck venous malformations (VMs) and lymphatic malformations (LMs) are rare congenital vascular anomalies.
- Limited series have reported on polidocanol sclerotherapy for these conditions.
Purpose of the Study:
- To evaluate the efficacy and safety of polidocanol sclerotherapy for head and neck VMs and LMs.
- To assess treatment response based on volume reduction and symptom resolution.
Main Methods:
- Retrospective observational study of 20 patients with head and neck VMs and LMs.
- Percutaneous or endoscopic intra-lesional 3% polidocanol microfoam sclerotherapy was administered.
- Clinical response was categorized as excellent, moderate, or poor based on MRI volume reduction and symptom resolution.
Main Results:
- Median volume decreased from 19.3 mL to 5.8 mL (mean reduction: 72.98%).
- Excellent-to-moderate response observed in 94.4% of cases.
- Mean volume reductions: 79.5% in macrocystic LMs, 76.1% in VMs, 60.5% in mixed LMs, and 42.5% in microcystic LMs.
Conclusions:
- Polidocanol sclerotherapy is an effective and safe treatment for head and neck VMs and LMs.
- Best responses were noted in macrocystic LMs and VMs.
- Mixed and microcystic LMs showed moderate and poor responses, respectively.
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