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Radiofrequency ablation in the treatment of paediatric microcystic lymphatic malformations

Published online by Cambridge University Press:  04 February 2013

J Goswamy*
Affiliation:
Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester, UK
S E Penney
Affiliation:
Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester, UK
I A Bruce
Affiliation:
Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester, UK
M P Rothera
Affiliation:
Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester, UK
*
Address for correspondence: Mr J Goswamy, Specialist Registrar in Otolaryngology, Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK Fax: +44 (0)161 701 5627 E-mail: [email protected]

Abstract

Objective:

Congenital lymphatic malformations are a challenging clinical problem. There is currently no universally accepted treatment for the management of microcystic disease. We describe the novel use of an existing technology (radiofrequency ablation, also termed Coblation) for the debulking of paediatric microcystic lymphatic malformations involving the upper aerodigestive tract.

Methods:

Five children with microcystic or mixed-type lymphatic malformations were included in this retrospective case series.

Results:

Each child had a satisfactory outcome following radiofrequency debulking, with improved oral intake and airway symptoms. No serious complications were reported. These findings constitute level IV evidence.

Conclusion:

We recommend radiofrequency ablation as a safe, viable alternative to existing techniques for the treatment of paediatric microcystic lymphatic malformations of the upper aerodigestive tract. Radiofrequency ablation achieves effective debulking of microcysts whilst avoiding excessive bleeding and thermal damage to surrounding tissues. This paper constitutes the first report of successful treatment of airway obstruction due to paediatric laryngopharyngeal microcystic disease, using radiofrequency ablation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2013

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Footnotes

Presented at the 10th International Congress of the European Society of Pediatric Otorhinolaryngology, 5–8 June 2010, Pamplona, Spain

References

1Burezq, H, Williams, B, Sachin, CA. Management of cystic hygromas: 30 year experience. J Craniofacial Surg 2006;17:815–18CrossRefGoogle Scholar
2Goetsch, E. Hygroma colli cysticum and hygroma axillare. Arch Surg 1938;36:394479CrossRefGoogle Scholar
3McClure, C, Sylvester, C. A comparative study of lymphatico-venous communication in adult mammals. Anat Rec 1909;3:353–4CrossRefGoogle Scholar
4Kennedy, TL, Whitaker, M, Pellitteri, P, Wood, E. Cystic hygroma/lymphangioma: a rational approach to management. Laryngoscope 2001;111:1929–37CrossRefGoogle ScholarPubMed
5Grimmer, JF, Mulliken, JB, Burrows, PE, Rahbar, R. Radiofrequency ablation of microcystic lymphatic malformations in the oral cavity. Arch Otolaryngol Head Neck Surg 2006;132:1251–6CrossRefGoogle ScholarPubMed
6Cable, BB, Mair, EA. Radiofrequency ablation of lymphangiomatous macroglossia. Laryngoscope 2001;111:1859–61CrossRefGoogle ScholarPubMed
7Bloom, DC, Perkins, JA, Manning, SC. Management of lymphatic malformations. Curr Opin Otolaryngol Head Neck Surg 2004;12:500–4CrossRefGoogle ScholarPubMed
8Ryu, NG, Park, SK, Jeong, HS. Low power radiofrequency ablation for symptomatic microcystic lymphatic malformation of the tongue. Int J Pediatr Otorhinolaryngol 2008;72:1731–4CrossRefGoogle ScholarPubMed
9Roy, S, Reyes, S, Smith, LP. Bipolar radiofrequency plasma ablation (Coblation) of lymphatic malformations of the tongue. Int J Pediatr Otorhinolaryngol 2009;73:289–93CrossRefGoogle ScholarPubMed
10Greene, D. Radiofrequency ablation of the tongue base in obstructive sleep apnoea: rapid and effective technique using low-temperature radiofrequency molecular disassociation (Coblation) for management of retroglossal obstruction. J Otolaryngol Head Neck Surg 2008;37:777–81Google ScholarPubMed
11Bhattacharyya, N, Kepnes, LJ. Clinical effectiveness of Coblation inferior turbinate reduction. Otolaryngol Head Neck Surg 2003;29:365–71CrossRefGoogle Scholar
12Friedman, M, Ibrahim, H, Joseph, NJ. Staging of obstructive sleep apnoea/hypopnoea syndrome: a guide to appropriate treatment. Laryngoscope 2004;114:454–9CrossRefGoogle ScholarPubMed
13Timms, MS, Bruce, IA, Patel, NK. Radiofrequency ablation (Coblation): a promising new technique for papillomata. J Laryngol Otol 2007;121:2830CrossRefGoogle ScholarPubMed