Na Detskej ORL klinike v spolupráci s Klinikou detskej chirurgie LF UK a DFNsP v Bratislave sme ošetrili 16 pacientov s lymfangiómom na hlave a krku. Priemerný vek pacientov bol počas hospitalizácie 6,6 roka. U siedmich detí sme vykonali totálnu exstirpáciu lymfangiómu, u siedmich detí subtotálnu exstirpáciu, u jedného dieťaťa došlo k spontánnej involúcii po sepse a u jedného pacienta došlo k regresii po liečbe Prednizonom. Primárne sme operovali 11 detí z nášho súboru 16 pacientov. Autori porovnávajú svoje skúsenosti so skúsenosťami iných autorov s liečbou lymfangiómov na hlave a krku u detí.

Lymphangiomas are due to their localization, extent and difficult treatment a serious problem not only for the patient from a cosmetic aspect with a potential social impact but are also a challenge for the surgeon from the aspect of repeated operations on account of relapses and sometimes also because they threaten the patient's life. The authors operated in 1996-2000 at the Paediatric ENT Clinic and the Paediatric Surgical Clinic (Paediatric Faculty Hospital with Policlinic and Medical Faculty Comenius University Bratislava) 14 children from a group of 16 patients with lymphangioma of the head and neck. The lymphangiomas were in 69% of the patients on the neck and in 31% on the head (tab. 1). One child had a lymphangioma on the head, neck and chest. The ratio of boys: girls was 1.3:1 (tab. 2). The mean age of the patients at the time of hospitalization was 6.6 years. Five children were operated on account of lymphangiomas originally in other departments and because of relapse were referred to the authors' department. The authors made primary operations in 11 children. In seven children they made a total extirpation of the lymphangioma and in seven children, because of the closeness of the cyst wall and surrounding structures they left small tissue remnants on the carotid artery, n. hypoglossus and r. marginalis mandibulae n. facialis. They performed thus a subtotal extirpation of the tumor. Spontaneous regression of the lymphangioma occurred in one patient after treatment of sepsis and infection in the lymphangioma and in another patient after prednisone treatment was started. In one 8-year-old with lymphangioma on the neck they decided to use conservative treatment with interferon. After initial treatment with prednisone complete regression of the lymphangioma occurred. The patient is now four years without a relapse. In the discussion the authors deal with different types of lymphangiomas, the localizations reported by different authors and their views on possible treatment. The authors consider surgery the only effective procedure in the treatment of lymphangiomas. The effect of prednisone on the regression of lymphangiomas remains open, although in some patients it may be the method of choice.

Detská ORL klinika LF Univ Kom a DFNsP Bratislava

Treatment of lymphangiomas of the head and neck in children

Liečba lymfangiómov na hlave a krku u detí = Treatment of lymphangiomas of the head and neck in children /

Lit: 29

Souhrn: eng