Sclerotherapy with picibanil (OK-432) for congenital lymphatic malformation in the head and neck

Hypothesis/Objectives: Congenital lymphatic malformations of the head and n eck (LMHN) present special challenges to the otolaryngologist-head and neck surgeon. Recently, a number of sclerotherapy trials have shown promising r esults. In this study, we present our experiences with picibanil (OK-432) s clerotherapy for this lesion. Study Design: Retrospectively review. Methods : We retrospectively reviewed 21 patients who have undergone selerotherapy with picibanil for LMHN. Results: Satisfactory response with complete or ne arly complete shrinkage of the lesions was observed in 15 cases after repea ted sclerotherapy (average, two times). We did not observe any significant morbidity or complications in the patients treated with picibanil. Reductio n in size of the mass was achieved in weeks to months. Some of the patients who had not had any other previous treatment showed remarkable reductions in size even after the first therapy. When we used picibanil sclerotherapy as a primary treatment for the LMHN, most of our patients showed satisfacto ry results regardless of the size or location of the lesions. Conclusion: G iven with our experience and the reports that failure of picibanil scleroth erapy does not hinder subsequent surgical salvage procedures, we recommend trying picibanil sclerotherapy as a primary treatment for the LMHN and perf orming surgical excision as a secondary modality if the response to the scl erotherapy is not satisfactory.