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淋巴管畸形是常见于头颈部的一种先天性发育畸形。临床上常用的治疗方法主要有手术切除、硬化治疗、激光治疗等,可根据病变类型和病变范围选择其中一种方法或几种方法联合应用。口腔黏膜的微囊型淋巴管畸形适用激光治疗、平阳霉素注射或几种方法联合治疗。累及口腔和面颈部的淋巴管畸形的治疗困难较多,弥漫性病变手术切除后易复发,并发症发生率高。病变内注射平阳霉素、溶血性链球菌制剂(OK-432)可用于淋巴管畸形的治疗,大囊型病变的疗效明显优于微囊型。围手术期硬化治疗可提高微囊型病变的治愈率。

Management of lymphatic malformations in oral and cervicofacial regions

Lymphatic malformations are congenital vascular lesions with a predilection for the oral and cervicofacial areas， and most frequently noted at birth. Surgical resection， sclerotherapy and laser ablation are the most commonly used modalities for their management. The selection of treatment methods mainly depends on the type and extent of lesions. Mucosal microcystic lesions are indicated for carbon dioxide laser photocoagulation and sclerotherapy with pinyangmycin or combined modalities. Lymphatic malformations involving the oral and cervicofacial regions are especially problematic from a functional or cosmetic point of view. Extensive lymphatic malformations in these regions run a high risk of morbidity or complications with surgery. Intralesional injection of sclerosing agents has been proposed as an alternative to the surgery or in combination with surgery for treatment of these malformations. Bleomycin or pinyangmycin and OK-432 have been successfully used for treatment of these lesions. The cervical macrocystic malformations have higher response rate to the sclerotherapy than microcystic lesions in the oral and facial regions. Peri-operative sclerotherapy may improve the treatment of microcystic malformations.