ArticleInternational journal of pediatric otorhinolaryngology2026
Multidisciplinary management of pediatric head and neck lymphatic malformations: a 10-year single-institution experience.
Article in International journal of pediatric otorhinolaryngology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPediatric head and neck lymphatic malformations (HNLM) are heterogeneous lesions that often require multimodal care. Contemporary real-world data incorporating evolving interventional techniques and targeted systemic therapy are limited. We describe patient characteristics, imaging utilization, treatment utilization/sequencing, and 90-day treatment-related complications within a multidisciplinary vascular anomalies program.
methodsRetrospective single-institution chart review of patients <18 years with head and neck lymphatic malformations through the Birthmarks and Vascular Anomalies Program (BVAP) from 2014 to 2024 (n = 59). Demographics, lesion characteristics, imaging, treatment sequencing, and 90-day treatment-related complications were abstracted from the medical record. Analyses were descriptive; procedure-level complication rates were reported with exact 95% confidence intervals (CIs).
resultsMorphology was 42.4% microcystic, 37.3% macrocystic, and 20.3% mixed; 39.0% were multiregional. Median lesion diameter was 4.0 cm (IQR 2.1-6.4). MRI was obtained in 93.2% of patients. Sclerotherapy was used in 67.8% (86 sessions), most commonly doxycycline (45.8%) and bleomycin (35.6%). Resection without embolization occurred in 45.8%, laser therapy in 15.3%, and glue embolization surgery in 5.1%. Systemic therapy included sirolimus in 25.4%, with 4 patients transitioning to alpelisib. Eight patients (13.6%) underwent molecular testing; all tested had pathogenic PIK3CA variants. Ten patients (16.9%) experienced ≥1 complication. Procedure-level complications occurred after 5/86 sclerotherapy procedures (5.8%; 95% CI 1.9-13.0), 6/53 resections without embolization (11.3%; 95% CI 4.3-23.0), and 0/3 glue embolization procedures (0.0%; 95% CI 0.0-70.8).
conclusionPediatric HNLM often required multimodal, staged treatment with high MRI utilization and repeat procedures. Prospective multicenter studies with standardized outcomes and systematic molecular testing are needed to guide lesion-specific care.
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