Publicado

2020-07-01

Diagnóstico y manejo de lesiones vasculares en cabeza y cuello de pacientes pediátricos de la Fundación Hospital de la Misericordia, período 2012–2019

Diagnose and care of head and neck vascular lesions in pediatric patients from Fundación Hospital de la Misericordia, from 2012–2019

DOI:

https://doi.org/10.15446/aoc.v10n2.86650

Palabras clave:

Linfangioma, malformaciones vasculares, escleroterapia, doxiciclina (es)
Lymphangiomas, vascular deformities, sclerotherapy, doxycycline (en)

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Objetivo: identificar el manejo y respuesta a tratamientos que presentaron los pacientes pediátricos diagnosticados con hemangiomas y malformaciones vasculares en cabeza y cuello, que acudieron al servicio de Cirugía Oral y Maxilofacial de la Fundación Hospital de la Misericordia (HOMI) durante el período 2012–2019. Métodos: 11 pacientes fueron atendidos en el servicio de cirugía oral y maxilofacial de la Fundación HOMI, entre enero de 2012 y noviembre de 2019, con diagnóstico de hemangioma y/o malformaciones vasculares. De estos, 9 fueron tratados con doxiciclina como agente esclerosante. Resultados: se atendieron 5 pacientes masculinos y 6 femeninos con rango de edad entre los 8 meses y 13 años, con un promedio de 86,8 meses. La escleroterapia se realizó con doxiciclina en dosis de 100 mg disuelta en una ampolla de bicarbonato de sodio de 10 ml, inyectada en 5 pacientes con ecografía y en 4 por aspiración directa. De los 11 pacientes, 9 fueron tratados con escleroterapia; de estos 5 recibieron una sesión de escleroterapia, mientras que a los otros 4 se les realizó entre 2 y 3 sesiones. En 5 pacientes fue posible hacer seguimiento, ya que la atención depende de la autorización de la EPS. Conclusiones: la doxiciclina como agente esclerosante utilizado en lesiones vasculares ha demostrado ser un medicamento seguro, de bajo costo y efectivo como tratamiento inicial de hemangiomas y malformaciones vasculares en la cara. El número de aplicaciones depende del tipo de lesión a tratar.

Objective: Identify the treatment provided to patients with hemangioma and vascular deformities diagnosis .in head and neck who resorted to Oral and Maxillofacial service in Fundación Hospital de la Misericordia (HOMI) from 2012-2019 and the outcome of this treatments. Methods: Eleven (11) patients were admitted and treated by the surgical and maxillofacial team in “Fundación Hospital la Misericordia HOMI”, between January 2012 and November 2019 with the hemangioma and vascular deformities diagnosis. Nine (9) of them were treated using doxycycline as a sclerosing agent. Results: Out of the eleven (11) patients, five (5) were males and the other six (6) were females, with an age range going from 8 months, up to 13 years, for an average of 86,8 months. A sclerotherapy was performed using doxycycline, with a dosage of 100 mg dissolved in a syringe with 10 mL of sodium bicarbonate on five (5) patients with ultrasound, and four (4) with direct aspiration. Out of the eleven (11) patients, five (5) received one sclerotherapy session the remaining four (4) received 2 or 3 sessions. In five (5) of the patients it was possible to complete follow-ups since the attention depends on their healthcare provider. Conclusions: Doxycycline as a sclerosing agent used in vascular lesions has demonstrated to be a safe treatment, with low cost, and effective as an initial treatment for hemangiomas and vascular deformities on the face. The number of sessions depend on the lesion that is going to be treated.

Referencias

Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982; 69(3): 412–422. http://doi.org/10.1097/00006534-198203000-00002

Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg. 1983; 18(6): 894–900. http://doi.org/10.1016/s0022-3468(83)80043-8

Brucker AL, Frieden IJ. Hemangiomas of infancy. J Am Acad Dermatol. 2003; 48(4): 477–493. http://doi.org/10.1067/mjd.2003.200

Denise M, Adams, Anne W. Lucky. Cervicofacial vascular anomalies. I. Hemangiomas and other benign vascular tumors. Seminars in Pediatric Surgery. 2006; 15(2): 124–132. https://doi.org/10.1053/j.sempedsurg.2006.02.010

Zhou Q, Zheng JW, Mai HM, Luo QF, Fan XD, Su LX, et. al. Treatment guidelines of lymphatic malformations of the head and neck. Oral Oncol. 2011; 47(12): 1105–1109. https://doi.org/10.1016/j.oraloncology.2011.08.001

Dasgupta R, Adams D, Elluru R, Wentzel MS, Azizkhan RG. Noninterventional treatment of selected head and neck lymphatic malformations. Journal of Pediatric Surgery. 2008; 43(5): 869–873. https://doi.org/10.1016/j.jpedsurg.2007.12.029

ISSVA. Classification of Vascular Anomalies. International Society for the Study of Vascular Anomalies. 2018. Disponible en: https://www.issva.org/classification

Hage AN, Beecham Chick JF, Srinivasa RN, Chauhan NR, Acord M, Gemmete JJ. Treatment of Venous Malformations:

The Data, Where We Are, and How It Is Done. Tech Vasc Interventional Rad. 2018; 21(2): 45–54. https://doi.org/10.1053/j.tvir.2018.03.001

Jamal N, Ahmed S, Miller T, Bent J, Brook A, Parikh S, Ankola A. Doxycycline sclerotherapy for pediatric head and neck macrocystic lymphatic malformations: A case series and review of the literature. International Journal of Pediatric Otorhinolaryngology. 2012; 76(8): 1127–1131. https://doi.org/10.1016/j.ijporl.2012.04.015

Hawkins CM, Chewning RC. Diagnosis and Management of Extracranial Vascular Malformations in Children: Arteriovenous malformations, venous malformations, and lymphatic malformations. Seminars in Roentgenology. 2019. https://doi.org/10.1053/j.ro.2019.06.004

Thomas DM, Wieck MM, Grant CN, Zeinati C, Howell LK, Anselmo DM. Doxycycline Sclerotherapy Is Superior in the Treatment of Pediatric Lymphatic Malformations. 2016; 27(12): 1846–1856. https://doi.org/10.1016/j.jvir.2016.08.012

Nehra D, Jacobson L, Barnes P, Mallory B, Albanese CT, Sylvester KG. Doxycycline sclerotherapy as primary treatment of head and neck lymphatic malformations in children. Journal of Pediatric Surgery. 2008; 43(3): 451–460. https://doi.org/10.1016/j.jpedsurg.2007.10.009

Brouillard P, Vikkula M. Vascular malformations: localized defects in vascular morphogenesis. Clin Genet. 2003; 63(5): 340–51. https://doi.org/10.1034/j.1399-0004.2003.00092.x

Bai Y, Jia J, Huang XX, Alsharif MJ, Zhao JH, Zhao YF. Sclerotherapy of Microcystic Lymphatic Malformations in Oral and Facial Regions. J Oral Maxillofac Surg. 2009; 67(2): 251–256. https://doi.org/10.1016/j.joms.2008.06.046

Shergill A, John P, Amaral JG. Doxycycline sclerotherapy in children with lymphatic malformations: outcomes, complications and clinical efficacy. Pediatr Radiol. 2012; 42(9): 1080–8. https://doi.org/10.1007/s00247-012-2406-2

Hurewitz AN, Lidonicci K, Wu CL, Reim D, Zucker S. Histologic changes of doxycycline pleurodesis in rabbits. Effect of concentration and pH. Chest. 1994; 106(4): 1241–1245. https://doi.org/10.1378/chest.106.4.1241

Farnoosh S, Don D, Koempel J, Panossian A, Anselmo D, Stanley P. Efficacy of doxycycline and sodium tetradecyl sulfate sclerotherapy in pediatric head and neck lymphatic malformations. Int J Pediatr Otorhinolaryngol. 2015; 79(6): 883-887. https://doi.org/10.1016/j.ijporl.2015.03.024

Gurgacz S, Zamora L, Scott NA. Percutaneous sclerotherapy for vascular malformations: A systematic review. Ann Vasc Surg. 2014; 28(5): 1335–1349. httsp://doi.org/doi/10.1016/j.avsg.2014.01.008

Kirse DJ, Suen JY, Stern SJ, Schaefer RF, Roberson PK. Histologic effect of doxycycline sclerotherapy on rat femoral nerve. Head Neck. 1996; 18(6): 506–511. httsp://doi.org/doi10.1002/(SICI)1097-0347(199611/12)18:6<506::AID-HED4>3.0.CO;2-6

Molitch HI, Unger EC, Witte CL, vanSonnenberg E. Percutaneous sclerotherapy of lymphangiomas. Radiology. 1995; 194(2): 343–347. https://doi.org/10.1148/radiology.194.2.7529933

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Cómo citar

Sánchez Moreno, M. A., & Esquivel Campo, D. L. (2020). Diagnóstico y manejo de lesiones vasculares en cabeza y cuello de pacientes pediátricos de la Fundación Hospital de la Misericordia, período 2012–2019. Acta Odontológica Colombiana, 10(2), 112-126. https://doi.org/10.15446/aoc.v10n2.86650