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Management of head and neck lymphatic malformations in children
N Fageeh1, J Manoukian, T Tewfik
1Department of Otolaryngology, McGill University Faculty of Medicine, Montreal, Quebec.
Insights
Lymphatic malformations (LM) are complex congenital conditions. Surgical excision is the primary treatment for most pediatric patients, with many treated before age seven.
Area of Science:
- Pediatric Surgery
- Vascular Anomalies
- Congenital Malformations
Background:
- Lymphatic malformations (LM) represent complex congenital anomalies with debated developmental and management pathways.
- Early diagnosis and intervention are crucial for managing these often asymptomatic but potentially progressive conditions.
Purpose of the Study:
- To review the clinical presentation, treatment modalities, and outcomes of pediatric patients with lymphatic malformations.
- To propose a management strategy for lymphatic malformations based on retrospective data.
Main Methods:
- Retrospective review of 35 patients treated for lymphatic malformation between 1985 and 1995.
- Analysis of patient demographics, clinical presentation, treatment approaches (surgical excision, needle aspiration), and outcomes.
Main Results:
- The majority of patients presented at birth, with 83% treated before age seven.
- Asymptomatic neck masses were the most common presentation (74%), frequently located in the posterior triangle (54%).
- Total surgical excision was performed in 63% of patients, partial excision in 20%, and needle aspiration in 17%.
Conclusions:
- Surgical excision remains the predominant treatment for pediatric lymphatic malformations.
- A structured management approach, considering presentation and location, is proposed for these complex vascular anomalies.
Abstract:
Lymphatic malformations (LM) are complex entities. Their development and management remain controversial. A retrospective review of 35 patients treated for lymphatic malformation over a 10-year period (1985-1995) is presented. The demographics of the cases, the method of presentation, treatment modalities, and outcomes are presented. The majority or patients presented at birth, and 83% were treated before the age of 7 years. The most common presentation was an asymptomatic neck mass (74%), of which 54% were in the posterior triangle and 17% were in the submandibular space. The treatment was primarily surgical excision: 22 (63%) patients had total surgical excision, 7 (20%) had partial excision, and 6 (17%) had needle aspiration. A proposal of management is presented.
