Sclerotherapy for lymphatic malformations of head and neck: Systematic review and meta-analysis.


Journal

Journal of vascular surgery. Venous and lymphatic disorders
ISSN: 2213-3348
Titre abrégé: J Vasc Surg Venous Lymphat Disord
Pays: United States
ID NLM: 101607771

Informations de publication

Date de publication:
01 2020
Historique:
received: 11 05 2019
accepted: 11 09 2019
pubmed: 18 11 2019
medline: 8 9 2020
entrez: 18 11 2019
Statut: ppublish

Résumé

Percutaneous sclerotherapy is a commonly used modality for treatment of lymphatic malformations (LMs) of the head, face, and neck. The safety and efficacy of sclerotherapy with various agents for diverse pathologic types of LMs have not been fully established. We present the results of a systematic review and meta-analysis examining the safety and efficacy of percutaneous sclerotherapy for treatment of LMs of the head, face, and neck. We searched PubMed, MEDLINE, and Embase from 2000 to 2018 for studies evaluating the safety and efficacy of percutaneous sclerotherapy of head, face, and neck LMs. Two independent reviewers selected studies and abstracted data. The primary outcomes were complete and partial resolution of the LM. Data were analyzed using random-effects meta-analysis. There were 25 studies reporting on 726 patients included. The overall rate of complete cure of any pathologic type of LM after percutaneous sclerotherapy with any agent was 50.5% (95% confidence interval, 36.6%-64.3%). Macrocystic lesions had a cure rate of 53.1% compared with cure rates of 35.1% for microcystic lesions and 31.1% for mixed lesions. Regarding agents, doxycycline had the highest cure rate (62.4%) compared with all other agents. Overall permanent morbidity or mortality was 1.2% (95% confidence interval, 0.4%-2.0%) with no deaths. I Our systematic review and meta-analysis of 25 studies and >700 patients found that percutaneous sclerotherapy is a safe and effective modality for treatment of LMs of the head, neck, and face.

Sections du résumé

BACKGROUND
Percutaneous sclerotherapy is a commonly used modality for treatment of lymphatic malformations (LMs) of the head, face, and neck. The safety and efficacy of sclerotherapy with various agents for diverse pathologic types of LMs have not been fully established. We present the results of a systematic review and meta-analysis examining the safety and efficacy of percutaneous sclerotherapy for treatment of LMs of the head, face, and neck.
METHODS
We searched PubMed, MEDLINE, and Embase from 2000 to 2018 for studies evaluating the safety and efficacy of percutaneous sclerotherapy of head, face, and neck LMs. Two independent reviewers selected studies and abstracted data. The primary outcomes were complete and partial resolution of the LM. Data were analyzed using random-effects meta-analysis.
RESULTS
There were 25 studies reporting on 726 patients included. The overall rate of complete cure of any pathologic type of LM after percutaneous sclerotherapy with any agent was 50.5% (95% confidence interval, 36.6%-64.3%). Macrocystic lesions had a cure rate of 53.1% compared with cure rates of 35.1% for microcystic lesions and 31.1% for mixed lesions. Regarding agents, doxycycline had the highest cure rate (62.4%) compared with all other agents. Overall permanent morbidity or mortality was 1.2% (95% confidence interval, 0.4%-2.0%) with no deaths. I
CONCLUSIONS
Our systematic review and meta-analysis of 25 studies and >700 patients found that percutaneous sclerotherapy is a safe and effective modality for treatment of LMs of the head, neck, and face.

Identifiants

pubmed: 31734224
pii: S2213-333X(19)30506-2
doi: 10.1016/j.jvsv.2019.09.007
pii:
doi:

Substances chimiques

Sclerosing Solutions 0

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

154-164

Informations de copyright

Copyright © 2019 Society for Vascular Surgery. All rights reserved.

Auteurs

Lucio De Maria (L)

Department of Neurosurgery, Mayo Clinic, Rochester, Minn. Electronic address: l.demaria@unibs.it.

Paolo De Sanctis (P)

Department of Neurosurgery, Humanitas University, Milan, Italy.

Karthik Balakrishnan (K)

Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn.

Megha Tollefson (M)

Department of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minn.

Waleed Brinjikji (W)

Department of Radiology, Mayo Clinic, Rochester, Minn.

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