Role of Bleomycin Sclerotherapy as a Non-surgical Method for the Treatment of Cystic Hygroma of Head and Neck Region-an
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ORIGINAL ARTICLE
Role of Bleomycin Sclerotherapy as a Non-surgical Method for the Treatment of Cystic Hygroma of Head and Neck Regionan Institutional Study Anoop M1 • Rajeev Kumar Nishad1
•
Shobhit Gupta1 • Yogendra Yadav2
Received: 27 September 2020 / Accepted: 4 November 2020 Ó Association of Otolaryngologists of India 2020
Abstract Cystic hygroma is a benign congenital tumor of lymphatic origin. Most common location is head and neck region. Bleomycin is an antineoplastic glycopeptide antibiotic agent with sclerosing property. In our present study, we used bleomycin for intralesional sclerotherapy for cystic hygromas of head neck region, as an alternative to surgical excision. We also statistically analyzed the pattern of cystic hygroma in head and neck region. Our present study was a prospective observational study of 40 patients. The study period was 18 months. All patients were given intralesional bleomycin at the dose of 0.5 mg / kg body weight, not exceeding 10 units at a time. The injection was repeated if required, at an interval of 4 weeks up to 4–5 times. Each patient was followed up at regular interval up to 1 year. Most common age group was found to be between 0–7 years (55%). Mean age was 6.9 years. Posterior triangle of neck was the commonest site (35%). Excellent response was noted in 24 patients (60%) while good response was noticed in 11 patients (27.5%). Poor
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12070-020-02273-2) contains supplementary material, which is available to authorised users. & Rajeev Kumar Nishad [email protected] Anoop M [email protected] Yogendra Yadav [email protected] 1
ENT Department F.H. Medical College Etmadpur, Dr. B.R. Ambedkar University, Agra, Uttar Pradesh State 283202, India
2
Radiology Department F.H. Medical College Etmadpur, Agra, Uttar Pradesh State 283202, India
response in 5 patients (12.5%). No major side effects noted with bleomycin sclerotherapy. No recurrence was noticed in our study. Intralesional bleomycin is a safe, simple, relatively cheaper and effective nonsurgical treatment method for cystic hygroma of head and neck region. It can be used as a first line treatment modality. Still, a lot of research is needed to establish it as a gold standard treatment modality for cystic hygroma.
Introduction A cystic hygroma is a benign congenital tumor of lymphatic origin. It usually appears on a child’s neck or head. The word ‘‘cystic hygroma’’ was coined by Werner in 1834. Hygroma in Greek means water containing tumor. They are soft tissue tumors of disputed origin reported for the first time by Redenbacker is 1828 [1]. The tumor is a multilocular one but occasionally it can be unilocular, where the term ‘‘hydrocele of neck’’ is used. It may be inflamed as a result of nasopharyngeal infection to cause some confusion in the diagnosis. There is no lymph node enlargement unless infected [2]. Totally three histopathological subtypes of cystic hygroma are noticed ie capillary lymp
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