Percutaneous sclerotherapy of massive macrocystic lymphatic malformations of the face and neck using fibrin glue with OK-432 and bleomycin

Efficacy of OK-432 Therapy for the Incisionless Treatment of Head and Neck Cystic Masses: Case series

“…In their study of massive macrocystic lymphatic malformations, Chen et al observed excellent outcomes with a combination of fibrin glue, OK-432 and bleomycin in 53% of patients, in comparison to good and partial outcomes in 33% and 13% of cases, respectively. 19 None of the patients required surgical excision. 19 Thyroglossal duct cysts account for 70% of congenital neck masses; these lesions have a bimodal age distribution in which 90% of patients present by the age of 10 years, with a second peak in young adulthood.…”

“…19 None of the patients required surgical excision. 19 Thyroglossal duct cysts account for 70% of congenital neck masses; these lesions have a bimodal age distribution in which 90% of patients present by the age of 10 years, with a second peak in young adulthood. 4 Surgery in the form of a classic Sistrunk procedure is the preferred method of management.…”

Orbital Lymphangioma-Case Report and Review of the literature

“…Bleomycin, a glucopeptide produced by Streptomyces Verticilus, which acts by breaking DNA chains with free radicals, affects tumor cells. Its side effects are erythema, edema, pain, local necrosis and flagellate hyperpigmentation (resolves with drug interruption) 14 .…”

Supramicrosurgical lymphatic‐venous anastomosis for postsurgical subcutaneous lymphocele treatment

“…Combined aspiration and compression is not always an effective treatment for the high rate of recurrence. Sclerosant agents cause fibrosis and obliteration of both lymphocele and ruptured lymphatic vessel, damaging the lymphatic drainage. The same side effect happens when performing macroscopic ligation of subcutaneous tissue containing lymphatic vessels.…”

“…Even sclerotherapy has been proposed and since Teruel reported first succesful case, employing povidone iodine for lymphocele, a lot of sclerosant agents have been used, mainly for pelvic, but even for subcutaneous lymphocele, such as bleomycin, OK‐432, polidocanol, sodium tetradecyl solfato, sodio azetroato, fibrin glue, etanol, and tetracicline. This therapy has the advantage of being very simple but the drawback is that these agents act by strong inflammation of lymphocele walls and lymphatic vessel, causing fibrosis and obliteration of both . Surgical treatment can consist in reexploration of the lymphocele and ligation of subcutaneous tissue where lymphatic vessels are presumed to be, without direct microscopic visualization.…”