Efficacy and Safety of Ethanolamine Oleate as Sclerotherapy in Children with Cystic Hygroma

Open Access

Abstract

Background: Cystic hygroma, a congenital lymphatic malformation, frequently occurs in the cervicofacial region and may cause airway obstruction, dysphagia, or cosmetic deformity. Traditional surgical excision carries risks of recurrence and morbidity, making minimally invasive approaches desirable. Ethanolamine oleate (EAO) has emerged as a promising sclerosing agent with favorable efficacy and safety profiles in pediatric populations. Aim of the study: To evaluate the efficacy and safety of ethanolamine oleate sclerotherapy in children with cystic hygroma. Methods & Materials: This prospective observational study enrolled 60 children aged 0-10 years with clinically and ultrasonographically confirmed cystic hygroma at Dhaka Shishu Hospital, Bangladesh, between January 2012 and June 2013. All patients underwent ultrasound-guided sclerotherapy with 5% EAO, with sessions repeated at 4-6-week intervals as required. Lesion size reduction, clinical response, and procedure-related complications were documented. Statistical analysis was performed using SPSS, with significance set at p < 0.05. Result: The mean patient age was 28.83 ± 29.59 months, with a male predominance (56.67%). Lesions were most commonly located in the neck (53.33%) and were predominantly macrocystic (63.33%). Patients received a mean of 1.8 ± 0.6 treatment sessions, with a mean injection volume of 2.6 ± 1.1 mL. Mean lesion size decreased significantly from 6.8 ± 2.7 cm to 0.9 ± 1.1 cm (p < 0.001), yielding a mean reduction of 87.5 ± 12.3%. Complete response was achieved in 80% of patients, with an overall favorable outcome of 96.67%. Adverse events were minor and transient, including temporary swelling (10%), tenderness (6.67%), redness (3.33%), and low-grade fever (6.67%). Conclusion: Ethanolamine oleate sclerotherapy is a highly effective, safe, and minimally invasive alternative to surgical management for pediatric cystic hygroma. Ultrasound-guided administration enables precise treatment, reduces recurrence risk, and minimizes procedural morbidity.