Doxycycline Sclerotherapy For Lymphatic Malformations Under Doppler Ultrasound Guide

Main Article Content

Sumayah Qahtan Midhat
Balsam S. Abdul-Hameed
Amer Murad Jebur

Keywords

Lymphatic malformations, Sclerotherapy , Doxycycline ,Doppler ultrasound guide

Abstract

Background: Lymphatic malformations are uncommon hamartomatous congenital malformations of lymphatic system that can manage by different percutaneous scleroting agents.
Aim of study: This prospective study is to assess the effectiveness of doxycycline in all types of lymphatic malformations in terms of dose calculation and number of sessions and to evaluate risks versus benefits.
Patients and method: one year period,(7) patients with simple Lymphatic malformations at the age (1- 23) years were treated using doxycycline ( 10mg/ml ) as percutaneous intralesional scleroting agent guided by Doppler Ultra -sound, Magnetic resonance imaging was obtained in follow ups 6 weeks postoperatively .
Results: there were (4) patients with macrocystic Lymphatic malformations (57.1%), (1) patient with microcystic Lymphatic malformations (14.3%) ,and (2) patients with combined Lymphatic malformations (28.6%) , there was complete resolution in( 6) patients (85.7%) including all types of Lymphatic malformations and residual lesion of (1) patient (14.3%) of combined type. All macrocystic type required only one session and the combined type required more sessions than other types, follow up range was (2-
7) months after complete resolution.
Conclusions: doxycycline is an effective, inexpensive, available scleroting agent that can achieve excellent result in all types of Lymphatic malformations with large doses even in small children with minor and manageable side effects.

Abstract 407 | pdf Downloads 202

References

1. Clough, J. G. (2006). Classification of vascular anomalies. Journal of Foot and Ankle Surgery, 45(6), 443–444. https://doi.org/10.1053/j.jfas.2006.11.001 .
2. Dasgupta, R., & Fishman, S. J. (2014). ISSVA classification. Seminars in Pediatric Surgery, 23(4), 158 161.https://doi.org/10.1053/j.sempedsurg.2014.06.016 .
3. Ramashankar, Prabhakar, C., Kumar, N., & Giraddi, G. (2014). Lymphatic malformations: A dilemma in diagnosis and management.
Contemporary Clinical Dentistry, 5, 119–122. https://doi.org/10.4103/0976-237X.128689 .
4. Gilony D, Schwartz M, Shpitzer T, Feinmesser R, Kornreich L,Raveh E,(2012), Treatment of lymphatic malformations: a more conservative
approach. J Pediatr Surg. 2012 Oct; 47(10):1837-42.doi: 10.1016/j.jpedsurg.2012.06.005. PMID: 23084194 .
5. Cordes, B. M., Seidel, F. G., Sulek, M., Giannoni, C. M., & Friedman, E. M. (2007). Doxycycline sclerotherapy as the primary treatment for head
and neck lymphatic malformations.Otolaryngology - Head and Neck Surgery, 137(6), 962–964. https://doi.org/10.1016/j.otohns.2007.08.013
ISBN: 978-0-323-41496-8.
6. Jeremy D Prager, MD, (2019), Skin Tumors, Vascular Lesions, Face and Neck ,emedicine.medscape.com, updated :may42 ,2019 .
7. Jason L Acevedo, MD, (2019), Lymphatic Malformation (Cystic Hygroma),,emedicine.medscape . com, updated :Jan 28 ,2019.
8. Burrows, P. E., Mitri, R. K., Alomari, A., Padua, H. M., Lord,D. J., Sylvia, M. B., Fishman, S. J., & Mulliken, J. B. (2008).Percutaneous sclerotherapy
of lymphatic malformations with doxycycline. Lymphatic Research and Biology, 6(3–4), 209–216. https://doi.org/10.1089/lrb.2008.1004 .
9. R., Basu, K. S., Ganguly, S. S., Saha, K., & Ahmad, S.(2019). Outcome and clinical efficacy of bleomycin and doxycycline percutaneoussclerotherapy for treatment of paediatric lymphatic malformations in a limited resource setting. International Journal of Contemporary Pediatrics, 6(4), 1652. https://doi.org/10.18203/2349-3291.ijcp20192771 .
10. Shaye, D. A., Burks, C. A., Gadkaree, S. K., Ncogoza, I.,Tuyishimire, G., Nyabyenda, V., & Gassore, A. (2020). Selfcompounded Doxycycline
Sclerotherapy for the Treatment of Lymphatic Malformations in Low-Resource Settings. World Journal of Surgery, 432 . https://doi.org/10.1007/s00268-020-05667-z .
11. Shergill, A., John, P., & Amaral, J. G. (2012). Doxycycline sclerotherapy in children with lymphatic malformations: Outcomes,
complications and clinical efficacy. Pediatric Radiology, 42(9),1080–1088. https://doi.org/10.1007/s00247-012-2406-2 .
12. Jamal N, Ahmed S, Millter T. Bent J, Brook A, Parikh S, Ankola A (2012): Coxycycline sclerotherapy for pediatric head and neck
macrocystic lymphatic malformations: a case series and reivew of the literature. Int. J Pediatri
Otorhinolaryngol. 2012 Aug;76(8):1127-31 .
13. Shiels, W. E., Kang, D. R., Murakami, J. W., Hogan, M. J., & Wiet, G. J. (2009). Percutaneous treatment of lymphatic malformations.
Otolaryngology - Head and Neck Surgery, 141(2), 219–224. https://doi.org/10.1016/j.otohns.2009.04.001 .
14. Lee, J. Y., Namgoong, J.-M., Kim, S. C., & Kim, D. Y. (2019). Early Experience of Doxycycline Sclerotherapy for Lymphatic Malformations.
Advances in Pediatric Surgery, 25(2), 44. https://doi.org/10.13029/aps.2019.25.2.44 .
15. Greene, A. K., Perlyn, C. A., & Alomari, A. I. (2011). Management of lymphatic malformations. Clinics in Plastic Surgery, 38(1), 75–82.
https://doi.org/10.1016/j.cps.2010.08.006.Successful Medical Treatment for Head and Neck Lymphatic Malformations. Case Reports in Otolaryngology, 2019, 1–3. https://doi.org/10.1155/2019/2076798 .
16. Thomas, D. M., Wieck, M. M., Grant, C. N., Dossa, A., Nowicki, D., Stanley, P., Zeinati, C., Howell, L. K., & Anselmo, D. M. (2016).
Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations. Journal of Vascular and Interventional Radiology, 27(12), 1846–1856.https://doi.org/10.1016/j.jvir.2016.08.012 .
17. Kavitha Ranganathan and Steven J. Kasten,(2020) , vascularanomalies, .Grabb and Smith Plastic Surgery, 8th Ed .(Vol.3),ch.27 (2020). Health
Kluwer, [2020]Identifiers: LCCN2019015649 | ISBN 9781496388247 .
18. Susanne Wiegand, MD, Behfar Eivazi, MD, Annette P.Zimmermann, MD,Andreas M. Sesterhenn, MD, PhD, JochenA. Werner, MD,
PhD,(2010), sclerotherapy of lymphangiomas ofthe head and neck, Accepted 4 June 2010Published online 24August 2010 in Wiley Online Library (wileyonlinelibrary.com). DOI:10.1002/hed.21552.
19. De Maria, L., De Sanctis, P., Balakrishnan, K., Tollefson, M.,& Brinjikji, W. (2020). Sclerotherapy for lymphatic malformations of head
and neck: Systematic review and meta-analysis. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 8(1), 154–164.
https://doi.org/10.1016/j.jvsv.2019.09.007 .
20. De Maria, L., De Sanctis, P., Tollefson, M., Mardini, S.,Garrity, J. A., Morris, P. P., Bendel, E., & Brinjikji, W. (2020). Sclerotherapy for low-flow vascular malformations of the orbital and periocular regions: Systematic review and metaanalysis. Survey of Ophthalmology, 65(1), 41–47 .
https://doi.org/10.1016/j.survophthal.2019.08.003 .
21. Coughlin, K., Flibotte, J., Cahill, A. M., Osterhoudt, K.,Hedrick, H., & Vrecenak, J. (2019). Methemoglobinemia in aninfant after sclerotherapy with high-dose doxycycline. Pediatrics,143(2). https://doi.org/10.1542/peds.2018-1642 .
22. Biswas, S. ., Bhagyasree, V. ., & Rathod, V. N. . (2022). A CHECKLIST OF BIRDS AND DIVERSITY OF AVIAN FAUNA IN MUDASARLOVA RESERVOIR OF VISAKHAPATNAM, INDIA . Journal Of Advanced Zoology, 42(02), 165–175. https://doi.org/10.17762/jaz.v42i02.51
23. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
24. Wankhade, L. N. . (2022). STUDY ON BUTTERFLY FAUNA OF KARANJA (GHADGE) TAHSIL OF DISTRICT WARDHA (MAHARASHTRA). Journal Of Advanced Zoology, 42(02), 186–193. https://doi.org/10.17762/jaz.v42i02.53