Efficacy and Safety of Bleomycin Sclerotherapy for Venolymphatic Malformations in Head and Neck Region with MRI Follow Up

Abstract

1.1. Purpose: Venolymphatic Malformations (VLM) are low flow, vascular lesions that commonly occur in the head and neck. Sclerotherapy has become the mainstay of treatment for these lesions as sclerotherapy is less invasive than surgical excision. Bleomycin is one of the sclerosing agents used for these malformations. The aim of our study was to assess the efficacy and safety of percutaneous bleomycin sclerotherabpy in head and neck VLMs. 1.2. Materials and Methods: Prospectively maintained procedural records were retrospectively reviewed to identify all patients with VLM who underwent percutaneous bleomycin therapy between 2012 and 2018. Demographic information, lesion and treatment details were collected through chart review. Treatment responses were evaluated objectively by manual volume measurements of the VLM on pre and post treatment MR/CT imaging. Subjective treatment evaluations were obtained with patient satisfaction responses during their clinic visit. Paired t test was used for pre and post treatment volume comparison and p<0.05 was considered significant. 1.3. Results: Twenty patients (13 Female; age range 6-67 years) were treated with clinical follow up of 15±16 months and imaging follow up of 28±17 months. All patients were followed clinically and were satisfied with their treatment and improved symptomatically. All lesions reduced in size on follow up subjective evaluation. Pre and post treatment imaging, available on 13 patients, showed a mean reduction of lesion by 57% (p= 0.02) after treatment. No peri-procedural complication was seen except for one patient (5 %) who developed hyperpigmentation at the site of ECG leads. 1.4. Conclusion: Our study confirms long term efficacy and safety of percutaneous sclerotherapy with bleomycin for VLMs in head and neck with MRI follow up.