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Lymphatic Malformations of the Head and Neck: A Proposal for Staging

Lymphatic Malformations of the Head and Neck: A Proposal for Staging Abstract Objective: To propose a staging system for patients with lymphatic malformations of the head and neck. Design: Retrospective chart review. Patients: Fifty-six patients were treated for lymphatic malformations from 1983 to 1993 at Children's Hospital and Medical Center, Seattle, Wash. The charts were reviewed for anatomic location of the lesion, preoperative and postoperative complications, number of procedures to control disease, long-term sequelae, and persistence of disease. Lesions were characterized as being unilateral or bilateral and suprahyoid and/or infrahyoid. The five patient groups were then compared with respect to the above categories. Results: Preoperative complications reviewed include preoperative infection, respiratory embarassment necessitating airway intervention, and feeding difficulties. Postoperative complications assessed were cranial nerve injury, wound infection, and seroma formation. Long-term sequelae included malocclusion, speech delay, and cosmetic deformity. The rate of persistent disease was also assessed. A staging system was developed based on a progression of extent of disease. Stage I patients (n=12) had unilateral infrahyoid disease and a 17% incidence of complications overall. Stage II patients (n=17) had unilateral suprahyoid disease and a 41% incidence of complications. Stage III patients (n=15) had unilateral suprahyoid and infrahyoid disease and a complication rate of 67%. Stage IV patients (n=5) with bilateral suprahyoid disease had a complication rate of 80%, while stage V patients (n=6) with bilateral suprahyoid and infrahyoid disease had a 100% incidence of complications. Conclusion: Anatomic location of lymphatic malformations of the head and neck can be used to predict prognosis and outcome of surgical intervention.(Arch Otolaryngol Head Neck Surg. 1995;121:577-582) References 1. Bill AH, Sumner DS. A unified concept of lymphangioma and cystic hygroma . Surg Gynecol Obstet . 1965;120:79-86. 2. Landing BH, Farber S. Tumors of the cardiovascular system . In: Atlas of Tumor Pathology . Washington, DC: Armed Forces Institute of Pathology; 1956. 3. Balikrishnan A, Bailey CM. Lymphangioma of the tongue: a review of pathogenesis, treatment and the use of surface laser photocoagulation . J Laryngol Otol . 1991;105:924-930.Crossref 4. Saijo M. Lymphangioma: a long-term follow-up study . Plast Reconstr Surg . 1975;56:642-651.Crossref 5. Cohen SR, Thompson JW. Lymphangiomas of the larynx in infants and children: a survey of pediatric lymphangioma . Ann Otol Rhinol Laryngol Suppl . 1986;127:1-20. 6. Glasson MJ, Taylor SF. Cervical, cervicomediastinal, and intrathoracic lymphangioma . Prog Pediatr Surg . 1991;27:63-83. 7. Ricciardelli EJ, Richardson MA. Cervicofacial cystic hygroma: patterns of recurrence and management of the difficult case . Arch Otolaryngol Head Neck Surg . 1991;117:546-553.Crossref 8. Emery PJ, Bailey CM, Evans JNG. Cystic hygroma of the head and neck: a review of 37 cases . J Laryngol Otol . 1984;98:613-619.Crossref 9. Hemmer KM, Marsh JL, Milder B. Orbital lymphangioma . Plast Reconstr Surg . 1988;82:340-343.Crossref 10. Stratton VC, Grant RN. Cervicomediastinal cystic hygroma associated with chylopericardium . Arch Surg . 1958;77:887-891.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Lymphatic Malformations of the Head and Neck: A Proposal for Staging

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1995.01890050065012
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: To propose a staging system for patients with lymphatic malformations of the head and neck. Design: Retrospective chart review. Patients: Fifty-six patients were treated for lymphatic malformations from 1983 to 1993 at Children's Hospital and Medical Center, Seattle, Wash. The charts were reviewed for anatomic location of the lesion, preoperative and postoperative complications, number of procedures to control disease, long-term sequelae, and persistence of disease. Lesions were characterized as being unilateral or bilateral and suprahyoid and/or infrahyoid. The five patient groups were then compared with respect to the above categories. Results: Preoperative complications reviewed include preoperative infection, respiratory embarassment necessitating airway intervention, and feeding difficulties. Postoperative complications assessed were cranial nerve injury, wound infection, and seroma formation. Long-term sequelae included malocclusion, speech delay, and cosmetic deformity. The rate of persistent disease was also assessed. A staging system was developed based on a progression of extent of disease. Stage I patients (n=12) had unilateral infrahyoid disease and a 17% incidence of complications overall. Stage II patients (n=17) had unilateral suprahyoid disease and a 41% incidence of complications. Stage III patients (n=15) had unilateral suprahyoid and infrahyoid disease and a complication rate of 67%. Stage IV patients (n=5) with bilateral suprahyoid disease had a complication rate of 80%, while stage V patients (n=6) with bilateral suprahyoid and infrahyoid disease had a 100% incidence of complications. Conclusion: Anatomic location of lymphatic malformations of the head and neck can be used to predict prognosis and outcome of surgical intervention.(Arch Otolaryngol Head Neck Surg. 1995;121:577-582) References 1. Bill AH, Sumner DS. A unified concept of lymphangioma and cystic hygroma . Surg Gynecol Obstet . 1965;120:79-86. 2. Landing BH, Farber S. Tumors of the cardiovascular system . In: Atlas of Tumor Pathology . Washington, DC: Armed Forces Institute of Pathology; 1956. 3. Balikrishnan A, Bailey CM. Lymphangioma of the tongue: a review of pathogenesis, treatment and the use of surface laser photocoagulation . J Laryngol Otol . 1991;105:924-930.Crossref 4. Saijo M. Lymphangioma: a long-term follow-up study . Plast Reconstr Surg . 1975;56:642-651.Crossref 5. Cohen SR, Thompson JW. Lymphangiomas of the larynx in infants and children: a survey of pediatric lymphangioma . Ann Otol Rhinol Laryngol Suppl . 1986;127:1-20. 6. Glasson MJ, Taylor SF. Cervical, cervicomediastinal, and intrathoracic lymphangioma . Prog Pediatr Surg . 1991;27:63-83. 7. Ricciardelli EJ, Richardson MA. Cervicofacial cystic hygroma: patterns of recurrence and management of the difficult case . Arch Otolaryngol Head Neck Surg . 1991;117:546-553.Crossref 8. Emery PJ, Bailey CM, Evans JNG. Cystic hygroma of the head and neck: a review of 37 cases . J Laryngol Otol . 1984;98:613-619.Crossref 9. Hemmer KM, Marsh JL, Milder B. Orbital lymphangioma . Plast Reconstr Surg . 1988;82:340-343.Crossref 10. Stratton VC, Grant RN. Cervicomediastinal cystic hygroma associated with chylopericardium . Arch Surg . 1958;77:887-891.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: May 1, 1995

References