Lymphatic malformations compromising the upper airway in children: ultrasound-guided intralesional focal sclerotherapy with bleomycin targeting culprit lesions
| Autor: | Kyoko Mochizuki, Masato Shinkai, Munetaka Masuda, Yukihiro Tsuzuki, Issei Kawakita, Yuma Yagi, Norihiko Kitagawa, Shota Shinohara, Hidehito Usui |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Injections Intralesional Culprit Asymptomatic Lesion 03 medical and health sciences Bleomycin 0302 clinical medicine 030225 pediatrics Lymphangioma Sclerotherapy medicine Humans Ultrasonography Interventional Retrospective Studies Antibiotics Antineoplastic Lymphatic Abnormalities medicine.diagnostic_test business.industry Infant Newborn Infant Magnetic resonance imaging General Medicine respiratory system medicine.disease respiratory tract diseases Airway Obstruction Stenosis Treatment Outcome Child Preschool Therapy Computer-Assisted Pediatrics Perinatology and Child Health 030211 gastroenterology & hepatology Surgery Female Radiology medicine.symptom business Airway |
| Zdroj: | Pediatric surgery international. 36(9) |
| ISSN: | 1437-9813 |
| Popis: | Lymphatic malformations (LMs) compromising the upper airway is a life-threatening and intractable disease. Here, we establish a novel method to perform intralesional focal sclerotherapy targeting the culprit for airway stenosis. Between July 2015 and February 2020, 11 patients with airway-compromising LMs were enrolled. To yield maximal effects on the compromised airway with minimal adverse effects, ultrasound-guided intralesional bleomycin sclerotherapy assisted by balloon was performed, aimed at the most responsible lesion around the airway. A retrospective analysis was performed. Ten patients presented with respiratory symptoms, eight of whom required airway support. The last asymptomatic patient showed airway compression on magnetic resonance imaging. The dose of bleomycin injected ranged from 1.3–9 mg per patient per course. A median of one course was required for withdrawal from airway support, and the median time was 15 days. A median of two courses was required to eliminate the lesion adjacent to the airway, which would have potential risk of airway stenosis. No complications were observed. Our intralesional focal sclerotherapy technique with bleomycin targeting the culprit lesion is dose-sparing, safe, and effective in achieving rapid shrinkage of LMs compromising the upper airway in children, thereby avoiding tracheostomy. |
| Databáze: | OpenAIRE |
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