Management of Cystic Lymphangioma in the Head and Neck Region

Abstract

Cystic lymphangiomas of the head and neck are very common and cannot be completely removed by surgical excision because of frequent complications. In this article, we report on 28 cases of huge cystic lymphangiomas in the head and neck region, which were treated successfully by endoscopic cautery in combination with postoperative intratumoral negative pressure. The cysts were 11 to 20 cm in diameter as diagnosed by ultrasonography and computed tomography scan. The 45-degree × 4-mm endoscopes were placed into the cysts through 1- to 2 cm-long hidden incisions to visualize the lymphangiomas, which were under the blue translucent mucous membranes. We cauterized the walls of the tumor cavities with 6% to 10% iodine twice and used topical negative-pressure therapy for 7 to 10 days after suture of the small incisions. This endoscopic approach can be successfully and safely performed by an experienced surgeon who complies with oncologic principles.