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Percutaneous injection of sclerosant agents as an effective treatment for cystic malformations of the head and neck

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Abstract

Purpose

To evaluate the clinical and aesthetic outcome of percutaneous injection of sclerosant agents to treat head and neck cystic malformations (HNCM) and to assess their recurrence rate based on histology and site.

Methods

Fifty-four subjects (mean age 46 years) with HNCM treated by percutaneous injection of sclerosant agents between January and December 2017 were included. Imaging and clinical data before and after the procedure were collected. Quality of Life Index, Pain Visual Analogue Scale, and Aesthetic Scale scores were measured to assess clinical and aesthetic outcomes. A size reduction of ≥ 70% assessed through the visual scale was considered significant.

Results

Of the 54 HNCM, there were 26 (48%) lymphatic malformations (LM), 13 (24%) salivary epithelial duct cysts of the parotid gland, 12 (22%) salivary mucoceles, and 3 (5%) branchial cysts. A significant size reduction and a satisfactory clinical-aesthetic outcome were observed in all types of LM. The number of reinterventions was significantly associated with the number of lesions (p < 0.001). The lowest number of interventions was observed in macrocystic lymphatic malformations (average of 1.2 interventions). All salivary epithelial duct cysts showed a significant reduction in size, a satisfactory clinical-aesthetic outcome, and an average of 1.16 interventions per patient. Mucoceles had a worse response, with only 3/14 patients showing a satisfactory and long-lasting clinical outcome (average of 1.16 interventions). Treatment of branchial cysts showed the worst outcome with a limited clinical response (3/3).

Conclusion

Percutaneous injection of sclerosant agents may be considered as a first-line treatment for LM and salivary epithelial duct cysts.

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Author contributions

Ilaria Paladini: design, conduct, analysis, and writing; Silvia Schirò: design, conduct, analysis, writing; Roberta Eufrasia Ledda: conduct and writing; Ludovica Leo: analysis; Gianluca Milanese: conduct; Enrico Epifani: conduct; Andrea Andreone: conduct; Giulia Capurri: conduct; Matteo Fantoni: conduct; Andrea Gemignani: conduct; Alessandro Gritti: conduct; Enrico Sesenna: conduct; Roberto Menozzi: design, conduct. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy

    Ilaria Paladini, Enrico Epifani, Andrea Andreone & Giulia Capurri

  2. Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy

    Silvia Schirò, Roberta Eufrasia Ledda, Ludovica Leo & Andrea Gemignani

  3. Unit of “Scienze Radiologiche”, Department of Medicine and Surgery (DiMeC), University Hospital of Parma, Parma, Italy

    Gianluca Milanese

  4. Neuroradiology Unit, Diagnostic Department, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy

    Matteo Fantoni

  5. Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma,, Parma, Italy

    Alessandro Gritti

  6. Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy

    Enrico Sesenna

  7. Interventional Neuroradiology Unit, Diagnostic Department, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy

    Roberto Menozzi

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  1. Ilaria Paladini
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Contributions

All data supporting the findings of this study are available within the paper and its Supplementary Information.

Corresponding author

Correspondence to Silvia Schirò.

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Ethics approval and consent to participate

This study was approved by the Institutional Review Board of the University Hospital of Parma (Comitato Etico Emilia Romagna Nord, 323/2018/OSS/AOUPR), compliant with HIPPA. Given the retrospective nature of the study, informed consent was waived.

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Written informed consent for publication of their details (photographs) was obtained from the study participants.

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The authors declare no competing interests.

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Paladini, I., Schirò, S., Ledda, R.E. et al. Percutaneous injection of sclerosant agents as an effective treatment for cystic malformations of the head and neck. Oral Maxillofac Surg 28, 809–818 (2024). https://doi.org/10.1007/s10006-024-01210-9

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