THE SURGICAL-MANAGEMENT OF GIANT CERVICOFACIAL LYMPHATIC MALFORMATIONS

Giant cervicofacial lymphatic malformation, a potentially life-threate ning congenital malformation,(1,2) historically has been removed in st aged resections.(3-5) However, complete surgical extirpation is desira ble and can be achieved with the aid of a multidisciplinary team, The authors present the case of a 12-year-old girl who had an extensively enlarged cervicofacial lymphatic malformation, Effective treatment inv olved aggressive surgical excision, facilitated by mandibular osteotom ies to provide access to the floor of the mouth, the tongue, and the p haryngeal wall, In addition, total removal of involved facial and neck skin was performed, The remaining soft tissue defect was reconstructe d primarily with an abdominal musculocutaneous free flap. In the 5 yea rs since the procedure, there has been no recurrence, Based on this ex perience, excision of involved skin and mandibular access osteotomies are important techniques to help completely remove cervicofacial lymph atic malformations with oral involvement, thus potentially reducing th e number of recurrences. In addition, these cases require the best eff orts of a multidisciplinary team to achieve a successful result so tha t complete and radical excision can be performed with the hope of avoi ding the pitfalls of multiple resections. Copyright (C) 1996 by W.B. S aunders company.