Comparative Study on Efficacy of Intralesional Bleomycin Injection in Head and Neck Lymphangioma and Vascular Malformation
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 12
Abstract
Introduction: Head and neck region is the most common site of occurrence for lymphangioma and vascular malformation. The surgical modality of treatment for these conditions carries higher risk of neurovascular damages, recurrence and bad scar. Intralesional Bleomycin Injection (IBI) has been used extensively as a non surgical treatment because of its low cost, easy availability and high sclerosing effect on vascular endothelium. Most of the researches have been focused on reporting its efficacy on lymphangioma or vascular malformation or haemangioma only. Aim: To compare the efficacy and safety of intralesional bleomycin injection in lymphangioma and vascular malformation of head and neck region. Materials and Methods: A prospective comparative study was carried out in the Department of ENT-HNS in Kathmandu Medical College Teaching Hospital, Nepal from January 2015 to June 2016. First 15 patients of lymphangioma (Group 1) and same number of slow flow vascular malformation (Group 2) were offered IBI in the dose of 0.5 mg/kg/dose (not exceeding 15 mg/ dose). The injection was repeated every three weeks, if needed. The size of the lesion was measured and serial photographs were taken. Complications were also recorded. The mean and standard deviation was calculated and results were compared using Chi-square and Student’s t-test. Results: Response rate (size reduction) between the groups was comparable (p=0.361). Mean number of injections required in Group 1 and Group 2 were 3 and 5 respectively. The number of injections required to meet the above mentioned response was statistically higher in Group 2 as compared to Group 1 (p=0.002). Apart from minor complications like fever and transient increase in swelling in both the groups (20%) and skin hyperpigmentation in Group 2 (13%), there were no haematological or pulmonary complication in due course of treatment and follow up. Conclusion: Intralesional bleomycin injection is equally effective for lymphangioma and slow flow vascular malformation but vascular malformations require significantly higher number of injections than lymphangioma.
Authors and Affiliations
Deepak Regmi, Meera Bista, Sangita Shrestha, Diva Shrestha, Nain Bahadur Mahato
Unusual Presentation of Porencephalic Cyst in an Adult
Porencephalic cyst is quite a rare entity in adults with only a few cases reported so far. It is usually congenital and seen in neonates. Here, we report a 28-year-old female who presented with post-ictal confusion follo...
The Effect of Metoclopramide Addition to Lidocaine on Pain of Patients with Grades II and III Post-Episiotomy Repair
Introduction: Episiotomy is the most common procedure used for dilatation of the vaginal opening for giving birth. Although episiotomy is associated with benefits for the mother, it may lead to short term and long term d...
Acquired Inhibitor of Factor VIII Presenting as Delayed Wound Healing
Acquired coagulation factor VIII inhibitor leads to a rare disease i.e., acquired haemophilia which is idiopathic in majority of cases and is seen with autoimmune diseases, haematologic and solid tumours, infections, in...
Assessment of Marginal Integrity of Proximal Composite Resin Restorations Performed with or without Magnification
Introduction: Composite resins are the most frequently used direct tooth coloured restorative materials. Their use in the posterior teeth has increased because of their improved mechanical performance and wear resistance...
Comparison of Cord Blood Lipid Profile in Preterm Small for Gestational Age and Appropriate for Gestational Age Newborns
Introduction: Coronary heart disease is one of the major causes of morbidity and mortality in current era. The roots of this epidemic have been traced to as early as foetal life by foetal origin hypothesis. There are a f...