口腔颌面部淋巴管畸形治疗指南

淋巴管畸形（lymphatic malformations）系淋巴系统先天性发育异常所形成的病变,虽有部分病例在成人时才出现,但90%在2岁内发病,约75%发生在头颈部。病变可因感染、创伤或出血而迅速增大,引起面部畸形,压迫呼吸道,造成进食及言语困难等。虽属良性病变,但极少自然消退。手术、硬化剂注射、激光治疗是目前的主要治疗方法,这些方法各有优缺点,应根据患者病情和医疗机构的技术条件,制定个体化治疗方案,对复杂病例,需采用综合序列治疗,以期获得最佳疗效。本文参考国内外相关文献和诊治经验,制定口腔颌面部淋巴管畸形治疗指南,希望对口腔颌面部淋巴管畸形的规范治疗起到指导作用。本指南将及时予以更新,以反映和纳入最新研究成果,为广大患者提供最好的治疗方案。

The protocol of treatment guideline of oral and maxillofacial lymphatic malformations

Lymphatic malformations,traditionally called lymphangiomas, are the disease caused by congenital abnormal development of lymphatic system. About 90% of the cases occur within 2 years except a few cases occur in adult, and approximately 75% of the lesions were located in the head and neck region. The lesions would grow rapidly with infection, trauma or bleeding, result in destruction of figure as well as severe impairment of respiration,swallow and speech. Although lymphatic malformations are benign lesions, they rarely involute spontaneously, their infiltrating nature coupled with the difficulty in distinguishing involved important structures of head and neck from adjacent normal tissue makes complete surgical resection even more difficult. The likelihood of postsurgical recurrence and complications is thus higher than other vascular lesions. Surgical resection,sclerotherapy and laser therapy are currently the main modalities for the treatment of lymphatic malformations. Due to the advantage and disadvantage which exist in each modality, the selection of treatment modalities should depend on the patient’s status and technique available. The treatment protocol should be individualized and comprehensive as well as sequential, to obtain the best treatment outcomes in complete cases. Based on the published literatures and clinical experiences, we establish a treatment guideline in order to provide a criteria for the man-agement of oral and maxillofacial lymphatic malformations.This protocol will be renewed and updated to include and reflect the cutting edge knowledge, and provide newest treatment modalities to benefit our patients.