Noninterventional treatment of selected head and neck lymphatic malformations

BackgroundIndications for treatment of lymphatic malformations include disfigurement, symptoms, and infection. Patients with lymphatic malformations often undergo resection or sclerotherapy to prevent possible complications, as it has been thought that lymphatic lesions do not regress.MethodsA retrospective analysis of all head and neck lymphatic malformations for the past 5 years was performed.ResultsTwenty-five patients with lymphatic malformations of the head and neck were treated, all underwent computed tomography or magnetic resonance imaging for evaluation. Fourteen patients had macrocystic lesions; others were considered mixed or microcystic. Seventeen patients underwent intervention. Ten patients underwent surgical resection alone, 4 patients underwent sclerotherapy, and 3 patients had both sclerotherapy and surgical resection. Of 17, 15 patients who underwent intervention had complications, including recurrence and nerve damage. Eight patients with predominantly macrocystic lesions were managed with close observation and were asymptomatic other than a mass. With follow-up of 33.4 months, in 4 of 8 patients, the lesion significantly decreased; 4 of 8 patients continue to be asymptomatic.ConclusionsPatients who undergo intervention have a high complication and recurrence rate. Selected patients with asymptomatic macrocystic lymphatic malformations of the head and neck can often be managed by observation alone. These patients should be followed closely in a multidiscliplinary clinical setting.