Sodium Tetradecyl Research Articles

Outcome evaluation for the treatment of low flow venous and lymphatic malformations

PurposeTo propose a standardized method of subjectively and objectively evaluating outcomes of sclerotherapy in treating low flow vascular malformations.Materials and methodsSixty-six patients with low flow vascular malformations (venous, lymphatic, or combined) were treated with percutaneous sclerotherapy using bleomycin, doxycycline, or sodium tetradecyl sulphate. Each lesion required between 2–5 sessions of sclerotherapy with 8-week intervals in between.The success of sclerotherapy was evaluated subjectively and objectively. The subjective response was based on the degree of patient satisfaction, by recording improvement of their symptoms and quality of life. The objective response was based on the changes in lesion characteristics after treatment, by recording changes in size, sonographic features, number of cystic spaces, and development of phleboliths.Results91% of our patients were satisfied with the treatment and reported improvement of symptoms and quality of life. Radiologically, 62% (41/66) of the patients had a reduction in lesion size, 77% (51/66) had a change in echogenicity, 84% (51/61) had a reduction in cystic spaces, and 68% (30/44) developed phleboliths. Of the patients reporting significant improvement, 94% displayed reduction in cystic spaces, 89% displayed change in the echogenicity and 71% showed changes in the size of the lesions, representing a linear correlation.ConclusionEvaluating the outcomes of percutaneous sclerotherapy for treating vascular malformations is a recognized challenge. Creating a questionnaire with defined parameters to apply before and after treatment allows objective measurement of outcomes. This will enable improved treatment pathways and treatment choice for patients, informed consent, and enable outcome comparison with other centers.

Efficacy of Sodium Tetradecyl Sulphate for the Treatment of Venous Malformation of The Head and Neck

Objective: To assess the efficacy of Sodium Tetradecyl Sulphate for the treatment of venous malformations of the head and neck region. Study Design: A prospective clinical study. Place and Duration of Study: Oral and Maxillofacial Surgery department of Sharif Medical and Dental College Lahore, Pakistan from Apr 2021- Apr 2022. Methodology: All the patients who met the inclusion criteria and were willing to take part in the study were enrolled. Pre-operative demographic data, clinical examination findings were noted in the specially designed proforma. The diagnosis was confirmed using doppler ultrasonography. 0.5-2ml of 3% STS was injected in the lesions transcutaneously or transmucosally depending on the location after aspiration and till blanching of the lesion occurred. Cases were followed up for 04 weeks and pre-op and post-op results were assessed independently by a consultant using the Achauer’s scale. Results: Total 22 patients were enrolled. Mean age in the study was 17+11.93 years. Male to female ratio was 1:2.1. Buccal mucosa and the tongue were the most common sites, involved in 7(31.8%) cases. Complete and partial resolution was obtained in 14(63.6%) 22 cases. There were no post op complaints in majority of the patients. Post op pain, ulceration and sloughing was reported by 2(9.1%) of the patients. Conclusion: The results of the study show that 3% STS was effective in reducing the size of the lesion to approximately 50% to the original size. Overall efficacy was found to be 63.6% with minimum morbidity and side effects.

Treatment of patients with venous malformations of the maxillofacial region by sclerosing

Objective. To evaluate the efficacy of 3% sodium tetradecyl sulfate in the foam form in treating patients with venous malformations (VMs) of the maxillofacial region. Materials and methods. In total, 30 patients with VMs of the maxillofacial region were included in the study. The patients were divided into three groups: (1) patients with a small VM size of up to 2 cm in diameter; (2) patients with an average VM size from 2 to 6 cm in diameter; (3) patients with a large VM size above 6 cm in diameter. In the treatment of patients, a foam form of 3% sodium tetradecyl sulfate was used. Results. All patients were treated without intraoperative and postoperative bleeding. According to the results of the study, large VMs decreased in size by an average of 49.7%, medium malformations decreased by an average of 68.1%, while small malformations decreased by 69.6%.Conclusion. Sclerosing of venous malformations of the maxillofacial region with a foam form of 3% sodium tetradecyl sulfate is an effective, affordable, and safe treatment method.

Comparative Study of Pyogenic Granuloma Management with Conservative Sclerotherapy to Invasive Surgical Excision: A Randomized Clinical Trial

Introduction: Pyogenic granuloma is a common benign reactive mucocutaneous lesion. Various treatment options like excision, sclerotherapy, cryotherapy, laser is widely practiced. Objective: This study was conducted to determine and compare the effect of 3% sodium tetradecyl sulfate to surgical excision in the management of oral pyogenic granuloma. Methods: The prospective randomized controlled trial was conducted among two equal randomly allocated groups (48 each) of histologically confirmed cases. Group A was treated by surgical excision while group B was treated by 3% STDS. Both groups were evaluated weekly for a month for pain and healing and 1st, 3rd & 6th for recurrence. Results: Pain score is statistically significant on 1st and 2nd week follow up. No clinical and statistical difference observed in pain on 3rd and 4th week. Clinically significant recurrence was observed in group ‘A’ (4.1%) than group ‘B’ on 3 months but was statistically insignificant. 1 recurrence was observed in group ‘B’ on 6 months whereas, 3 were reported from group ‘A’ in the same duration. Healing on 1st and 2nd weeks were comparable and statistically significant in both groups however the results failed to show any significant difference on 3rd and 4th week. The demographics showed mean age 30.97±12.4 years with 60.42% of incidence in female and the commonest site being mandibular anterior teeth (25%). Conclusion: Although, surgical excision is commonly practiced, it is associated with higher recurrence, increased pain score & prolonged healing period. On contrary, sclerotherapy with 3% STDS proved to be safer, minimally invasive and more accepted by patients with minimum postoperative morbidity.

Exploring Bleomycin vs. Setrol Injections in Adults.

This retrospective study aimed to assess the efficacy of bleomycin and sodium tetradecyl sulphate (STS) as sclerotherapeutic treatment modalities for low-flow vascular and lymphatic malformations. A total of 30 patients in age group of 9-60 years with vascular and lymphatic anomalies in the head and neck region were included in our study and divided into two groups of 15 each. Patients in group 1 received bleomycin injections, while group 2 received STS for treatment. They were followed up in records for two years to look for resolution/ relapse/ recurrence of lesions. The no. of injections depended on the lesion size and response after the first and subsequent doses. Results showed that both drugs effectively treated these lesions, with no significant differences in efficacy and safety profiles. However, injection bleomycin had a slightly better cure rate (72%) than STS (61%). Both drugs required similar number of injections to be administered for a similar level of cure. Sclerotherapy provides a precious, non-invasive alternative to surgery in patients with slow-flow vascular and lymphatic anomalies. However, further research is needed to explore potential limitations and avenues for improvement.

Transjugular antegrade transvenous obliteration, with and without portal decompression, for management of rectal variceal hemorrhage

PurposeTo report antegrade transvenous obliteration, with or without concurrent portosystemic shunt creation, for the treatment of hemorrhagic rectal varices.Materials and methodsEight patients, including five (62.5%) females and three (37.5%) males, with mean age of 55.8 ± 13.8 years (range: 30–70 years), underwent transjugular-approach antegrade transvenous obliteration of rectal varices, with or without portosystemic shunt creation. Demographic data, procedural details, technical success of variceal obliteration, clinical success, adverse events, and follow-up outcomes were retrospectively recorded. Clinical success was defined as resolution of rectal hemorrhage.ResultsPortal venous access was achieved via a transjugular intrahepatic approach in all patients. The inferior mesenteric vein was selected, and foamy sclerosant (1:2:3 mixture by volume of ethiodized oil: sodium tetradecyl sulfate: air) was injected into the rectal varices with antegrade balloon occlusion in seven (87.5%) and without balloon occlusion in one (12.5%). Five of eight (62.5%) patients underwent concomitant transjugular intrahepatic portosystemic shunt (TIPS) creation (mean diameter 8.4 ± 0.9-mm) immediately following transvenous obliteration. Technical success of variceal obliteration was achieved in all patients. There were no immediate post-procedural adverse events. There were no reported occurrences of rectal ischemia, perforation, or stricture following obliteration. Two (40%) of the patients who underwent concomitant TIPS creation developed hepatic encephalopathy within 30 days of the procedure, which was medically managed. Clinical resolution of hemorrhage was achieved in all patients with no recurrent rectal variceal hemorrhage during mean follow-up of 666 ± 396 days (range: 14 − 1,224 days).ConclusionTransvenous obliteration, with or without concurrent TIPS creation, is feasible with promising results for the management of rectal variceal hemorrhage.

Innovations in the management of epistaxis secondary to hereditary hemorrhagic telangiectasia: our evolution to injection sclerotherapy as the treatment of choice.

We compared the efficacy of intralesional sclerotherapy using 3% sodium tetradecyl sulfate with non-sclerotherapy-based treatments for Hereditary Hemorrhagic Telangiectasia-associated epistaxis management. This is a retrospective study of patients who underwent surgical intervention for HHT-associated epistaxis management from 01/2010-02/2024. Patients undergoing sclerotherapy with intralesional 3% sodium tetradecyl sulfate were included in the sclerotherapy group and others undergoing conventional non-sclerotherapy-based procedures in the non-sclerotherapy group. Outcomes like breakthrough epistaxis, emergency visits, intra-op blood loss, blood transfusions, and procedure complications in the 3-month perioperative period were compared. Twenty-three patients who underwent 74 intranasal procedures were identified. In the sclerotherapy group, 17 patients underwent 47 procedures. In the non-sclerotherapy group, 10 patients underwent 27 procedures. Till the 3rd post-treatment month, fewer breakthrough epistaxis episodes were observed after sclerotherapy procedures (13/47) vs. non-sclerotherapy procedures (14/27); (p = 0.037). Intraoperative blood loss was significantly lower during sclerotherapy (median: 10 ml) vs. non-sclerotherapy procedures (median: 50 ml); p < 0.001. The time interval between successive procedures was not significantly different in the sclerotherapy (median 6.5 months) vs. the non-sclerotherapy group (median 3.5 months); p = 0.13. Nasal crusting was the most common complication in the sclerotherapy group (36.9%). Two patients in each group had new onset septal perforation, none of the patients had vision loss or cerebrovascular accident. One emergency department visit was reported in the sclerotherapy group vs. 7 (in 3 patients) in the non-sclerotherapy group. Compared to non-sclerotherapy treatments, intralesional sclerotherapy for epistaxis in HHT is more effective in decreasing breakthrough epistaxis, and has lower intraoperative blood loss.

Injectable agents for the induction of Peyronie's disease in model rats: a comparative study.

Peyronie's disease (PD) is a disorder characterized by fibrous plaque formation in the penile tissue that leads to curvature and complications in advanced stages. In this study, we aimed to compare four injectable induction agents for the establishment of a robust rat model of PD: transforming growth factor-β1 (TGF-β1), fibrin, sodium tetradecyl sulfate (STS) combined with TGF-β1, and polidocanol (POL) combined with TGF-β1. The results showed that injection of TGF-β1 or fibrin into the tunica albuginea induced pathological endpoints without causing penile curvature. The STS + TGF-β1 combination resulted in both histological and morphological alterations, but with a high incidence of localized necrosis that led to animal death. The POL + TGF-β1 combination produced pathological changes and curvature comparable to STS + TGF-β1 and led to fewer complications. In conclusion, fibrin, STS + TGF-β1, and POL + TGF-β1 all induced PD with a certain degree of penile curvature and histological fibrosis in rats. The POL + TGF-β1 combination offered comparatively greater safety and clinical relevance and may have the greatest potential for PD research using model rats.

Sclerotherapy vs. surgical excision for lymphatic malformations of the head and neck: a systematic review and meta-analysis.

Lymphatic malformations (LMs) are abnormal lymphatic vessels with cystic characteristics, categorized as macrocystic, microcystic, or a combination of both. They represent the second most common vascular malformations, and their management involves multidisciplinary approaches based on clinical assessments and imaging studies. LMs manifest as a challenge to medical professionals in the head and neck, posing functional and aesthetic concerns. Our systematic review aims to compare the efficacy of sclerotherapy and surgery for LMs, identifying optimal treatment modalities for each scenario. We searched four electronic databases for related studies. Data were extracted from the included studies. We calculated the pooled rate ratios with 95% confidence intervals (CIs). The I2 test was used to detect heterogeneity. The inclusion of the studies required the following prerequisites: 1- Studies focusing on any lymphatic malformations in the head and neck, whether microcystic, macrocystic, or a mix of both; 2- Studies performed on more than ten patients; 3- All interventions used as surgery, sclerotherapy, or both. We included 58 studies in our systematic review, of which 45 were eligible for the meta-analysis. For macrocystic LMs, sodium tetradecyl sulfate (STS) mixed with ethanol and excision achieved the highest complete response rates at (92.9%) and (92.5%), respectively. Surgical excision showed the lowest poor response rate. Polidocanol microfoam had the highest poor response rate (11.1%). In microcystic LMs, combining sclerotherapy with excision showed the highest complete response rate (70.3%) and the lowest poor response rate (1.3%). Picibanil had the lowest complete response rate (9.1%) and the highest rate of poor response (61.4%). In mixed LMs, surgical excision had the highest complete response rate (70.3%). Both surgical excision and STS combined with ethanol are highly effective for treating macrocystic LMs, achieving similar complete response rates. The combination of sclerotherapy and surgical excision demonstrated the best outcomes in microcystic LMs. Surgical excision demonstrates superior efficacy over sclerotherapy for mixed LMs. These findings suggest that excision is generally more effective in achieving complete and excellent responses across all LM subtypes. Further high-quality studies are necessary to standardize and optimize treatment protocols.

Effect of the mixed micelles of zwitterionic-anionic surfactant on efficiency of antibiotic azithromycin dihydrate

The study highlights the importance of mixed micelles in enhancing the binding and solubilization properties of partially water-soluble medications, using zwitterionic cocoamidopropyl betaine (CAPB) and anionic sodium tetradecyl sulfate surfactants. Surface tension and fluorescence spectroscopy evaluated the critical micelle concentration (CMC) of CAPB-STS mixed micelle. The thermodynamic parameters were assessed using Clint, Rubingh, and Motomura’s approach, which showed a synergistic interaction between the CAPB and STS. UV spectroscopy technique was used to evaluate the applicability of mixed micelle to enhance the solubility and binding constant (Kb) of antibiotic azithromycin dihydrate (AZI). Kb values of AZI were increased from 2.301 to 3.415 and molar solubilization ratio (MSR) values of AZI were increased from 0.228 to 0.801 by decreasing αCAPB from 0.9 to 0.1. The result indicated that zwitterionic CAPB was an electrostatic interaction consisting of both attractive (−CH2COO¯ group) and repulsive (−N+ group) interactions with AZI (−NH+ group), causing AZI molecules to reside in the Stern layer. While STS consisted of a negative −SO4¯ head group, it caused increased electrostatic interaction, and AZI penetrated the palisade layer of mixed micelles. At 7.00 mmolL-1 concentration of αCAPB 0.1, the solubility of AZI in water was increased to 2.77 mmol/L from 0.0032 mmol/L. Additionally, after 8 h, the controlled release of AZI in PBS at pH 7.4 was 95.58 % and decreased up to 30.77 % at αCAPB 0.1 mixed micelles. The observation of controlled AZI release from αCAPB 0.9 to 0.1 indicates that AZI molecules were strongly bound to mixed micelles by both hydrophobic and electrostatic interactions. In the end, a mixed micelle of CAPB-STS could serve as a useful drug-solubilizing agent in pharmaceutical applications.

Combination Foam and Liquid Sclerotherapy for Lower Extremity Reticular and Telangiectatic Veins: A Single-Center Retrospective Study.

Lower extremity reticular and telangiectatic veins are of common cosmetic concern. To retrospectively evaluate results of lower extremity sclerotherapy using a combination of foam and liquid sclerosing agents. A retrospective chart review of sclerotherapy patients at a dermatology practice (January 2014 to April 2023) was performed. Eight hundred and nine patients (775 women and 34 men) with a mean age of 49.6 ± 12.2 (18-84) years underwent a mean 1.4 ± 0.7 (1-7) sessions. Multiple different sclerosing agents were used, with 0.2% sodium tetradecyl sulfate foam/liquid predominating, although 72% glycerin liquid and 0.25% to 0.5% polidocanol foam/liquid were also used. Coagula occurred in 61.0% of patients at 2 weeks and 6.4% at 3 months, whereas postsclerotherapy hyperpigmentation was seen in 5.0% and 19.1% of patients at the same time points. Both were more common after first-round treatment, each with a trend toward decreased frequency with increasing session number. Telangiectatic matting was found in 2.3% of 3-month follow-up patients. Edema, superficial venous thrombophlebitis, migraines, and ulceration were rarely seen. Significant clinical improvement was noted in 72.0% of treatments. This retrospective chart review, the largest to date of its kind, confirms the safety and efficacy of cosmetic lower extremity sclerotherapy with a combination of foam and liquid sclerosing agents.

Hemangioma of the buccal mucosa treated with sclerotherapy: A rare case report

Hemangiomas are common benign vascular anomalies that can occur in various locations throughout the body, including the oral cavity. The lesions are generally asymptomatic and exhibit a variation in the size and colour. Here, we present a case report of a hemangioma located in the buccal mucosa of a 40-year-old female patient who presented with asymptomatic reddish purplish swellings in the buccal mucosa, which had gradually increased in size over the last 6 months. Clinical examination and imaging studies confirmed the diagnosis of a hemangioma. 1 ml of 3% of sclerosing agent (sterol; sodium tetradecyl sulphate) mixed with lignocaine HCL was injected in the periphery of the lesion, once a week for 3 weeks, and periodic follow-up evaluation revealed a marked reduction in the lesion size. This case demonstrates the feasibility and efficacy of sclerotherapy as a minimally invasive treatment option for hemangiomas of the buccal mucosa, particularly in cases where surgical excision may be technically challenging or associated with significant morbidity.

Investigation of the effect of poly (sodium styrene sulfonate) on sodium glycodeoxycholate and sodium tetradecyl sulfate mixed micelle

Investigation of the effect of poly (sodium styrene sulfonate) on sodium glycodeoxycholate and sodium tetradecyl sulfate mixed micelle

INFERIOR RECTUS FIBROSIS AND RESIDUAL DIPLOPIA FOLLOWING SCLEROTHERAPY FOR ORBITAL VENOUS MALFORMATION

Orbital vascular lesions are challenging to treat and observation is often preferred if symptoms are mild. Historically, surgical excision of the lesions used to be the preferred treatment, but intraoperative bleeding and incomplete removal were common. Therefore, sclerotherapy has become the treatment of choice by virtue of being minimally invasive and extremely effective. Sclerotherapy involves multiple intralesional injections of sclerosing agents like bleomycin and sodium tetradecyl sulfate. In this communication, we describe an unusual complication associated with sclerotherapy to treat an orbital venous malformation in a young woman diagnosed with a type-2 low flow venous malformation (orbital varices) in her left orbit. There was complete resolution of the lesion. However, following the procedure, she complained of diplopia accompanied by left hypotropia. The condition persisted six months after the procedure. Forced duction test confirmed a tight inferior rectus and she refused any further intervention. This case report discusses the possible mechanisms of this rare and unusual complication associated with sclerotherapy while treating orbital vascular lesions.

(O-24) EFFICACY OF ASPIRATION AND SCLEROTHERAPY FOR HYDROCELE: A SYSTEMATIC REVIEW

Abstract Introduction and Objetives Hydroceles are abnormal collection of fluid between the parietal and visceral layers of the tunica vaginalis. Traditionally, surgical excision and or repair under general anaesthesia has been the standard of care, but sclerosant therapy can be used safely and with efficacy for hydrocele’s treatment. This study aims to review and elucidate the current literature sclerotherapy for hydrocele. Methods We searched for articles in Pubmed, Embase and Cochrane evaluating aspiration and sclerotherapy for hydrocele treatment. Search terms were “hydrocele” and “sclerotherapy”. Relevant papers references were full reviewed searching for new articles. The sclerosing agents considered eligle were phenol, tetracycline, sodium tetradecyl sulfate, phenol and alcohol. Results We included 1554 patients from 26 studies. Mean aspirative hydrocele volume was 238,3 mL. Cure rate was seen in 58,3% to 76% after a single procedure in STDS studies and 70% to 94,11% overall success. Phenol’s studies demonstrated a 47.5% to 70% cure rate with one sclerotherapy and 96.5% to 100% overall success. In Sclerotheraphy with tetracycline cure rate after a single procedure was 57% to 100% and overall success was 77% to 100%. Of the polidocanol group, cure rate was 42.3% to 62.1% after one sclerotherapy and overall success was 51.7% to 94%. Finally, in alcohol’s group we found 50% to 76.12% after one procedure and 80% to 97.62%. Conclusion A better cure rate after one procedure was observed with tetracycline and overall success after multiples procedures was seen with phenol. Due to heterogeneity and biases of the studies, more controlled clinical trials must be done to elucidate the best sclerosant agents. Financing No conflict.

Whole-lesion assessment of volume and signal changes after sclerotherapy of extremity venous malformations

PurposeTo investigate quantitative changes in MRI signal intensity (SI) and lesion volume that indicate treatment response and correlate these changes with clinical outcomes after percutaneous sclerotherapy (PS) of extremity venous malformations (VMs). MethodsVMs were segmented manually on pre- and post-treatment T2-weighted MRI using 3D Slicer to assess changes in lesion volume and SI. Clinical outcomes were scored on a 7-point Likert scale according to patient perception of symptom improvement; treatment response (success or failure) was determined accordingly. ResultsEighty-one patients with VMs underwent 125 PS sessions. Treatment success occurred in 77 patients (95 %). Mean (±SD) changes were –7.9 ± 24 cm3 in lesion volume and –123 ± 162 in SI (both, P <.001). Mean reduction in lesion volume was greater in the success group (–9.4 ± 24 cm3) than in the failure group (21 ± 20 cm3) (P =.006). Overall, lesion volume correlated with treatment response (ρ = –0.3, P =.004). On subgroup analysis, volume change correlated with clinical outcomes in children (ρ = –0.3, P =.03), in sodium tetradecyl sulfate–treated lesions (ρ = –0.5, P =.02), and in foot lesions (ρ = –0.6, P =.04). SI change correlated with clinical outcomes in VMs treated in 1 PS session (ρ = –0.3, P =.01) and in bleomycin-treated lesions (ρ = –0.4, P =.04). ConclusionsChange in lesion volume is a reliable indicator of treatment response. Lesion volume and SI correlate with clinical outcomes in specific subgroups.

Enhancing solubilization of Nebivolol hydrochloride through tuning pluronic F-127 with ionic Surfactants: An experimental and theoretical investigation

In the present work, the interaction of the antihypertensive drug Nebivolol hydrochloride (NBL) with nonionic surfactant pluronic F-127 (F-127) is investigated in an aqueous medium. Two ionic surfactants, viz., cationic, cetyl trimethyl ammonium bromide (CTAB) and anionic, sodium tetradecyl sulphate (STS) were added to F-127 to improve the physicochemical properties of the single micellar medium. The characterization techniques employed were, FTIR, UV–visible spectroscopy, dynamic light scattering, zeta potential, antioxidant, conductivity, and FESEM studies. The critical micellar concentration (CMC) of CTAB and STS are estimated from the conductivity experiments which is lowered due to the addition of F-127 and NBL. The lowering of CMC is attributed to the solubilization of NBL in the binary micellar mediums. The extent of binding of NBL in F-127, F-127 + CTAB, and F-127 + STS were quantified by determining the binding constant values using the Benesi–Hildebrand (B-H) plot from UV absorbance data. They were, 838.2 M−1 for F-127 1100.7 M−1 for F-127 + CTAB and 1836.5 M−1 for F-127 + STS systems. There was an increase in the size of the micelle due to the encapsulation of the drug in both binary micellar systems. The zeta potential (ZP) values displayed enhanced stability of the drug in binary micellar systems. The radical scavenging activity (RSA %) of NBL was estimated to be 16.5 % in F-127, 24.7 % in F-127 + CTAB, and 44.9 % in F-127 + STS systems. The encapsulation efficiency (EE %) for the above three systems were 14.7 %, 16.4 % and 18.5 %, respectively. The surface parameters and the interactions were verified through molecular docking studies. The results suggest that the properties of F-127 can be improved by tuning with ionic surfactants to solubilize NBL. To our knowledge, this is the first report of NBL solubilization in mixed micellar systems. Similar studies with other drug systems can be applied to get improved results.

Experience in the treatment of lymphatic malformations in children

BACKGROUND: In the treatment of lymphatic malformations, the problem of radical removal and a high risk of recurrence remains.&#x0D; AIM: Improving the efficiency of treatment of children with lymphatic malformations by introducing new surgical methods and optimizing sclerotherapy.&#x0D; MATERIAL AND METHODS: The results of treatment of 150 patients with lymphangiomas and an experimental study of the effects of sclerosing drugs on the lining of lymphangioma are presented. The study included 67 (44.7%) girls and 83 (55.3%) boys. The patients were divided into three groups. The first group (72 children) consisted of patients with radical removal of lymphangioma. The second group included 70 patients with partial resection of lymphangioma and sclerosis of residual cavities. The third group (8 children) consisted of patients operated on by video endoscopic method. A histological study of micropreparations of lymphangioma after sclerosis with ethanol and sodium tetradecyl sulfate with an exposure of 5 minutes was carried out. Statistical analysis was carried out using the StatTech v. 2.2.0 using methods of parametric and non-parametric analysis. Results were considered statistically significant at p 0.05.&#x0D; RESULTS: In the first group of patients, 9 (11.1%) relapses occurred, in the second — 12 (12.3%), in the third group — 0 relapses. Treatment combined with sclerotherapy did not lead to a significant increase in the recurrence rate (p=0.541). Types of lymphatic malformations and their location did not significantly affect the risk of recurrence (p=0.232 and p=0.552, respectively). Sclerosis of the lymphangioma lining with 70% ethanol and a liquid form of sodium tetradecyl sulfate caused total desquamation of the endothelium. Sclerosing with the foam form of sodium tetradecyl sulfate led to total desquamation of the endothelium during a 3-minute exposure.&#x0D; CONCLUSION: The introduction of minimally invasive methods of treatment and the improvement of sclerosis will make the results of treatment of children with lymphangiomas better.

Indications, Outcomes, Efficacy, and Complications of Percutaneous Sclerotherapy in the Management of Hemangiomas at Kenyatta National Hospital

Background The effective management of hemangiomas using percutaneous sclerotherapy optimizes desired clinical outcomes and minimizes the associated complications in affected patients. Intra-lesional sclerotherapy involves injecting a sclerosing agent (such as bleomycin and sodium tetradecyl sulfate) into a lesion or the interstitial space around the lesion, causing endothelial injury, thrombosis, inflammation, scarring, and shrinkage of the lesion. Extensive literature suggests that sclerotherapy has a role in the management of hemangiomas, as demonstrated by better health outcomes and improved quality of life among affected patients. Objectives To evaluate the indications, outcomes, efficacy, and complications of percutaneous intra-lesional sclerotherapy in the management of hemangiomas. Materials and methods The study was a prospective cross-sectional study, conducted at a level 6 National Referral Hospital Interventional Radiology Unit. Patients with hemangiomas referred for intralesional sclerotherapy were treated. Data including the indications of intra-lesional sclerotherapy, short-term outcomes, complications were collected, analyzed, and presented in percentages, graphs, pie charts, tables. Technical and clinical success rates were calculated. The efficacy of intralesional sclerotherapy was analyzed using chi-square test. Results A total of 20 patients with hemangiomas were treated. There were 11 females comprising 55% and 9 males comprising 45% with a male to female ratio of 1:1.2. The commonest indication for referral was pain (21.6%), followed by abnormal swelling (18.9%). Most lesions were located in the liver comprising 25%. Other locations included the hand, cheek, lower lip, lower extremities (calf, distal leg, foot, and thigh), lumbar region, posterior thoracic back region and abdomen mesenteric region. Majority of the patients had significant improvement of clinical symptoms with a p-value &lt;0.05. Similarly, there was a statistically significant reduction in the sizes of the lesions treated with a p-value of &lt;0.05. The technical success rate was 100% and the overall clinical success rate was 90%. Mild pain (10%), mild edema (10%) and skin discoloration (5%) were the commonest minor complications encountered, with no major complications. Conclusion Percutaneous intralesional sclerotherapy is a safe and efficacious treatment of hemangiomas with a high technical and clinical success rate. It should be considered as a first line of treatment for the hemangiomas.

Sclerotherapy for Oral Vascular Malformation Using Sodium Tetradecyl Sulfate: Case Series

Vascular malformations in the oral cavity are congenital vascular anomalies with potential functional and aesthetic im-plication. Over the years, the demand for effective and minimally invasive treatments for oral vascular malformations has increased. This study presents a case series of six patients diagnosed with oral vascular malformations, who underwent sclerotherapy using sodium tetradecyl sulfate. Treatment showed satisfying results without any recurrence.