Comparative study of treatment option for pediatric Lymphangioma in head neck region

Open Access

Abstract

Background: Pediatric lymphangioma (cystic hygroma) is a congenital lymphatic malformation commonly affecting the head and neck region and may cause functional and cosmetic morbidity. Optimal management remains debated, particularly in resource-limited settings. Aim of the study: To compare the outcomes, recurrence rates, and complications of different treatment modalities for pediatric head-and-neck lymphangioma. Methods & Materials: This prospective comparative study was conducted at a tertiary pediatric surgical center in Bangladesh from August 2023 to August 2025. Sixty children (≤5 years) with clinically and radiologically confirmed lymphangioma were managed by complete surgical excision, intralesional sclerotherapy, or a combination of both. Treatment outcomes, recurrence, and procedure-related complications were recorded and analyzed descriptively. Result: Macrocystic lesions were the most common (56.67%), followed by microcystic (26.67%) and mixed types (16.67%). Sclerotherapy alone was the most frequently used treatment (50.00%). No recurrence was observed following complete surgical excision or surgery after sclerotherapy, whereas sclerotherapy alone showed a recurrence rate of 43.33%. Surgical treatment was associated with wound infection (10.00%), seroma (15.00%), and temporary nerve weakness (5.00%), while sclerotherapy-related complications included fever/pain (13.33%) and skin necrosis (6.67%). Conclusion: Both surgery and sclerotherapy are effective treatment options for pediatric head-and-neck lymphangioma. Complete surgical excision offers excellent disease control with no recurrence, while sclerotherapy provides a less invasive alternative with acceptable safety but higher recurrence. Treatment selection should be individualized based on lesion type, extent, and available resources.