Abstract:
Background: Lymphatic malformations are
localized areas of malformed lymphatic system that
can either be congenital or acquired which
commonly occur in the head and neck region.
Several treatment options for lymphatic
malformations have been proposed, despite this,
there is no consensus as to optimal management.
Objective: To determine the pattern and
management of head and neck lymphatic
malformations in a tertiary health facility in
Tanzania.
Material and Methods: This was a one-year cross sectional study that involved patients with head and
neck lymphatic malformations treated in Muhimbili
National Hospital. A structured questionnaire was
used to collect information including age and sex of
the patient, chief complaint and, duration, size and
site of the lesion. The treatment modalities were
surgery and/or intralesional bleomycin injection
(IL-Bleo) using a locally developed algorithm. A
standard dose of bleomycin was 0.3 to 0.6 mg/kg per
injection not exceeding 15 units per cycle with a maximum of 6 cycles.
Results: a total of 33 patients were included in the
study. Males were 21 (63.6%) and the male to female
ratio was 1.8:1. The age of patients ranged from 5
months to 28 years with a median age of 6 years. In
29 (87.9%) patients, the lesions were evident during
birth. The median area covered by the lesion in
2
patients was 12.00 cm . Nine (27.3%) patients were
managed by surgery alone, while majority (24,
72.7%) were given intralesional bleomycin (IL Bleo), of whom majority (20, 83.3%) required
surgical intervention subsequently. The overall
outcome of management of patients was considered
successful in 87% of patients.
Conclusion: Head and neck lymphatic
malformations are more common in males. Most of
the lymphangiomas are of congenital type.
Combining IL-Bleo and surgery an effective way of
managing head and neck lymphatic malformations.
