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Aesthetic considerations in extirpation of melolabial lymphatic malformations in children.

Abstract：

:Surgical treatment of lymphatic malformations in the nasolabial region of children has produced disappointing results. Attempts to remove them through a preauricular incision have generally required a synchronous superficial parotidectomy in an attempt to prevent facial nerve injury. However, incomplete removal with this approach is common, leading to multiple surgeries, infections, facial nerve injury, and when parotidectomy is performed, a lateral facial concavity. To avoid these complications and still extirpate the lymphatic malformation, an alternative direct external technique has been employed since 1986. A retrospective review of nine children with melolabial lymphatic malformations so managed was undertaken to assess treatment outcome. All patients underwent computed tomography (CT) or, more recently, magnetic resonance imaging (MRI) scans to define the anatomic limits of the lymphatic malformation and its relationship to the facial musculature. Scans differentiated localized lesions (resectable) from diffuse lesions (unresectable). All patients underwent direct external soft-tissue excisional debulking by means of melolabial incisions with perialar and/or supra-white roll extensions as needed. The mean age at time of surgery was 5.6 years. Complications were considered minor: One patient developed a small hematoma for which no specific treatment was necessary; four patients required antibiotics for cellulitis. The mean age at follow-up was 5.25 years. The mean number of procedures necessary to achieve final outcome was 3.25. The mean number of episodes of postoperative cellulitis was 1.8. There was a high level of patient and parent acceptance of facial scars. No patient required secondary scar revision. The external approach addresses the pathology directly, removes a greater overall percentage of abnormal tissue than the traditional hemirhytidectomy approach, and avoids potential injury to the facial nerve and the deforming concavity resulting from parotidectomy.

journal_name

Plast Reconstr Surg

journal_title

Plastic and reconstructive surgery

authors

Witt PD,Martin DS,Marsh JL

doi

10.1097/00006534-199507000-00007

subject

Has Abstract

pub_date

1995-07-01 00:00:00

pages

48-57

issue

eissn

0032-1052

issn

1529-4242

journal_volume

pub_type

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Aesthetic considerations in extirpation of melolabial lymphatic malformations in children.