Diagnosis and surgical treatment of cervical macrocystic lymphatic malformations in infants

Ma,Jing; Biao,Ruan; Lou,Fan; Lin,Ken; Gao,Ying‑Qin; Wang,Mei‑Lan; Yang,Yan‑Li; Zhang,Tie‑Song

doi:10.3892/etm.2017.4703

Diagnosis and surgical treatment of cervical macrocystic lymphatic malformations in infants

Authors:
- Jing Ma
- Ruan Biao
- Fan Lou
- Ken Lin
- Ying‑Qin Gao
- Mei‑Lan Wang
- Yan‑Li Yang
- Tie‑Song Zhang
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Affiliations: Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China, Department of Otolaryngology, The First Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China
Published online on: June 28, 2017 https://doi.org/10.3892/etm.2017.4703
Pages: 1293-1298
Copyright: © Ma et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The treatment of lymphatic malformations (LMs) represents a great clinical challenge. The present study reported on the treatment of 68 infants with cervical macrocystic LMs using surgical resection. The cases were retrospectively analyzed. All patients underwent pre‑operative ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) examinations. The surgery was performed under general anesthesia with endotracheal intubation. Ultrasonograms showed that 24 cases were monolocular, 44 were multilocular, 16 had no echo, 20 had a uniform low‑level echo and 32 had a non‑uniform low‑level echo. CT showed non‑enhancing low‑attenuating cystic lesions and attenuation values of 10‑45 HU. The magnetic resonance images of the LMs showed a low signal intensity on T1‑weighted imaging (WI) and a high signal intensity on T2‑WI. Complete resection was achieved in 56 patients, subtotal resection in eight and partial resection in four. Two complications were noted, including reversible paresis of the marginal mandibular branch of the facial nerve and a surgical‑site infection. One patient in whom partial resection was achieved had recurrence at ~2 months after the surgery. Ultrasonography, CT and MRI clearly demonstrated the size, shape, extent and adjacent structures of LMs, which aided in surgical planning and assessment of potential risks. Surgical excision increased the chances of cure and was relatively safe for infants aged <1 year. Location and extent, rather than age, were determined to be the most important factors for successful surgical treatment.

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