Along with the overview, the authors present the review of their patients between January 1, 1998, through December 31, 2008, with respect to age and sex distribution, symptoms, clinical presentation, management, treatment outcome, and follow-up.When the malformations occur in the tongue, the symptoms may include hemorrhage, excessive salivation, speech disturbances, difficulties chewing and swallowing, airway obstruction, and orthodontic abnormalities such as mandibular prognathism and malocclusion. Functional impairment and cosmetic deformity significantly affect the quality of life of patients with lymphatic malformations of the tongue.
Twenty patients (13 male and 7 female) with microcystic lymphatic malformations of the tongue were included in the evaluation. Their ages at initial presentation ranged from newborn to 20 years (mean age, 7.4 years). Thirteen of them had been treated at another hospital before the initial presentation at our department. The treatment methods included surgical reduction, laser therapy, corticosteroid therapy, and OK-432 (Picibanil; Chugai Pharmaceutical Co, Ltd, Tokyo, Japan) injections.The authors present the classification of lymphatic malformations (photo credit)
- Isolated superficial microcystic lymphatic malformations of the tongue (stage I)
- Isolated lymphatic malformations of the tongue with muscle involvement (stage II; stage IIA, involving a part of the tongue; stage IIB, involving the entire tongue)
- Microcystic lymphatic malformations of the tongue and the floor of mouth (stage III)
- Extensive microcystic lymphatic malformations involving the tongue, floor of mouth, and further cervical structures (stage IV)
In the present series of patients with microcystic lymphatic malformations of the tongue, it was possible to perform complete excision with a CO2 laser in all patients with stage I disease and in 3 patients with stage IIA disease. …….. The advantages of the CO2 laser compared with conventional surgery include less postoperative edema, tissue trauma, and blood loss……... For stages I and IIA microcystic lymphatic malformations of the tongue, CO2 laser surgery seems to be an excellent curative treatment option. In stages IIB, III, and IV disease, CO2 laser surgery seems to be useful as a part of a combined or staged approach.
The combination of antibiotics and short-duration systemic corticosteroids usually leads to a reduction of symptoms and a decrease of swelling and inflammation as described in patient 2.