Laryngeal Obstruction by Cervical and Endolaryngeal Lymphatic Malformations in Children: Proposed Staging System and Review of Treatment

Berg, Eric E.; Sobol, Steven E.; Jacobs, Ian N.

doi:10.1177/000348941312200907

Cited by 29 publications

(15 citation statements)

References 19 publications

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“…A subset of these children will have primarily laryngeal and/or upper airway involvement. 11 Severity of disease and clinical presentation for individual cases could not ascertained using this database approach; thus, it is not possible to determine which patients were selected for surgery. Given that the adverse event rate was fairly low, this is encouraging, as it is possible that interventional radiology techniques are being utilized more and the role for surgical case selection appears to be able to select for those with better chances of avoiding adverse events.…”

Section: Discussionmentioning

confidence: 99%

30-Day outcomes analysis of NSQIP-pediatric for surgical management of head and neck lymphatic malformations in children

Cheng

Liu

Lee

2019

International Journal of Pediatric Otorhinolaryngology

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Objective: Identify adverse events associated with surgical management of head and neck lymphatic malformations in children by investigating a US national database. Data source: Pediatric American College of Surgeons (ACS) National Surgical Quality Improvement Program ® (ACS NSQIP ® -pediatric), years 2012 -2016.Methods: Subjects included children under 18 years with a postoperative diagnosis of International Classification of Diseases (ICD), 9th revision code: 228.1 -lymphangioma, any site or ICD-10 code D18.1.Results: 163 patients were identified. 67 (41.1%) were female and 96 (58.9%) were male. The median age was 4.2 years (interquartile range [IQR] 1.6 to 11.3 years). Sixty-five (39.9%) underwent head and neck procedures. 19 (11.7%) patients with 30-day adverse events were identified, with unplanned reoperation being the most common; in the head and neck surgery group, there were 5 (7.7%). There was no significant difference in the occurrence of adverse events between head and neck surgery and the non-head and neck surgery group (p = 0.2238). Conclusions:No individual patient clinical factors were identified to be associated with increased rates of 30-day adverse event rates for surgical management of lymphatic malformations in children. Our investigation highlights the need for quality improvement to help decrease 30-day adverse events for surgery for this group, as the rate was quite high overall (11.7%). The wound complication rate was very low, but we observed a non-negligible number of reoperations and readmissions. Improving quality of care for surgical management of lymphatic malformations in children should focus future investigations on limiting reoperations and readmissions within the first 30 days postoperatively.

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Section: Discussionmentioning

confidence: 99%

30-Day outcomes analysis of NSQIP-pediatric for surgical management of head and neck lymphatic malformations in children

Cheng

Liu

Lee

2019

International Journal of Pediatric Otorhinolaryngology

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“…So far, the tracheotomy is inevitable for severe airway compromise. Berg et al [ 3 ] previously proposed a staging system to help guide treatment and predict clinical outcomes for chronic obstruction of the pediatric airway with massive cervicofacial lesions. The authors claimed that decannulation was available for the patients at early stage compared to the patients with more severe condition.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, the LM located at the neck is still challenging for the physician due to its complicated anatomical relationship among the surrounding vital tissues such as airway and nerves. Additionally, some fatal complication such as airway obstructions and impairment of oral feeding remains another obstacle for the choice of the treatment such as the surgery [ 3 , 4 ]. Thus, a novel strategy by using a simple and safe procedure to preserve the normal anatomical structure around the lesion is worthy of evaluation.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Lauromacrogol Foam Sclerotherapy for the Treatment of Acute Airway Compression Caused by Lymphatic Malformations in Infants

Wang

Fan

Huang

2018

BioMed Research International

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Management of LMs still remains a challenge especially for those suffering from complications such as acute airway compression. In this study, we retrospectively evaluated the efficacy and safety of percutaneous lauromacrogol foam sclerotherapy for the patients with acute airway compression caused by lymphatic malformations (LMs) in infants. Five cases of infants with acute airway compression caused by LMs were treated with lauromacrogol foam sclerotherapy in the radiology department from February 2013 to August 2015 at Wuhan Medical and Healthcare Center for Women and Children, China. By CT examination and the DSA imaging, LMs were diagnosed and progressed cervical and sublingual LMs combined with hemorrhages were observed and suppression of the trachea was noticed as well, resulting in the difficulty with breathing and feeding. For all the patients, we extracted most cyst liquid from the LMs to reduce the surface tension and alleviate the respiratory pressure symptoms under the guidance of ultrasound. Subsequently, the lauromacrogol foam was injected percutaneously into the cyst of LMs. The dose of the agent was determined according to the size of the LMs, which was 3-8 ml in our study. After treatment, autonomous respiration and independent eating were observed. When the procedures were completed after 16 cycles, the cyst cavity became atrophic and then nearly vanished. During the follow-up period (a minimum of three months and a maximum of two years), 4 patients were clinically proved to be cured and one patient was significantly improved. There was no recurrence, serious complications, or adverse reactions. Our study demonstrated that percutaneous sclerotherapy combined with lauromacrogol foam is a safe, effective therapy for acute airway compression caused by LMs, especially giving a good cosmetic result.

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“…Head and neck lymphatic malformations rarely involve the airway, and they are even less likely to be isolated to the larynx. [1][2][3] We present the case of a 2-year-old child who presented with airway obstruction initially diagnosed as laryngomalacia but subsequently diagnosed and treated for an isolated epiglottic lymphatic malformation.…”

Section: Introductionmentioning

confidence: 99%

Isolated Epiglottic Lymphatic Malformation in a 2-Year-Old: Diagnosis and Treatment

et al. 2016

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Airway obstruction in children has a wide differential diagnosis that includes laryngomalacia, infectious processes, paralysis, extrinsic compression, and other rare anatomic anomalies. Isolated laryngeal lymphatic malformations are rare developments that can manifest with clinically significant airway obstruction. To the best of our knowledge, there have been fewer than 20 reported cases. These laryngeal mucosal lesions are best managed with radiofrequency ablation or laser ablation. We present a case of a 2-year-old child who presented with airway obstruction, initially diagnosed with laryngomalacia, who was subsequently diagnosed and treated for an isolated epiglottic lymphatic malformation.

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Laryngeal Obstruction by Cervical and Endolaryngeal Lymphatic Malformations in Children: Proposed Staging System and Review of Treatment

Abstract: Lymphatic malformations obstructing the larynx require a careful and often staged management approach. A proposed staging system helps to predict the need for tracheotomy and the likelihood of long-term tracheotomy dependence.

Cited by 29 publications

References 19 publications

30-Day outcomes analysis of NSQIP-pediatric for surgical management of head and neck lymphatic malformations in children

30-Day outcomes analysis of NSQIP-pediatric for surgical management of head and neck lymphatic malformations in children

Percutaneous Lauromacrogol Foam Sclerotherapy for the Treatment of Acute Airway Compression Caused by Lymphatic Malformations in Infants

Isolated Epiglottic Lymphatic Malformation in a 2-Year-Old: Diagnosis and Treatment

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