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Sklerotherapie bei Erkrankungen im HNO-Bereich

Sclerotherapy for cystic lesions of the head and neck region

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Zusammenfassung

Zystische Raumforderungen (zRF) im Kopf-Hals-Bereich (KHB) sind relativ häufig. Ihre komplette operative Entfernung ist v. a. bei ausgedehnten Befunden und Kontakt zu neurovaskulären Strukturen mit verschiedenen Komplikationen verbunden. Eine Alternative zur chirurgischen Resektion stellt in ausgewählten Fällen die Sklerosierung mit OK-432 dar. Die Erfolgsrate bei lymphatischen Malformationen liegt durchschnittlich bei 60%. Nebenwirkungen treten selten auf. Die Therapie ist minimal invasiv, einfach, ambulant und damit kostengünstig, meist ohne Allgemeinanästhesie, durchführbar. Nervenläsionen oder kosmetisch störende Narben sind nicht beschrieben. Wird eine konsekutive Operation erforderlich, ist sie ohne zusätzliche Schwierigkeiten durchführbar. Der Nachteil besteht in wiederholten Injektionen bei ausbleibender Regredienz des Befundes. Selten kann sich ein Abszess bilden, der einer chirurgischen Therapie bedarf. Vor der Sklerotherapie ist zytologisch ein Malignom auszuschließen. Die intrazystische Injektion von OK-432 ist eine effektive Methode zur Behandlung von zRF im KHB.

Abstract

Cystic lesions are frequently occurring diseases of the head and neck region. Complete surgical resection near to neurovascular structures can be accompanied by various complications. In selected cases intralesional injection of OK-432 could constitute an alternative. The average success rate of sclerotherapy of lymphatic malformations is 60%. Side effects are rare. Sclerotherapy is a minimally invasive, simple and cost-effective procedure performed without general anaesthesia at the outpatient clinic. Nerve lesions or troublesome scarring do not occur. In residual cases surgical excision is realisable without any difficulty. Repeated injections of sclerotherapy agents represent a disadvantage. Abscess formation has been observed as a rare complication. A malignant disease has to be excluded by cytological examination before commencing sclerotherapy. The intracystic injection of OK-432 is an effective treatment modality for cystic cervical lesions.

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Danksagung

Für die Bereitstellung der histologischen Schnitte bedanken wir uns bei Herrn Dr. W.D. Schmitt, Pathologisches Institut der MLU Halle-Wittenberg. Die Abb. 7 verdanken wir Frau PD Dr. S. Kösling, Universitätsklinik für diagnostische Radiologie der MLU Halle-Wittenberg.

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  1. Universitätsklinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie der Martin–Luther-Universität Halle-Wittenberg, Magdeburger Straße 12, 06097, Halle/Saale, Deutschland

    S. Knipping & G. Goetze

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Correspondence to S. Knipping.

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Knipping, S., Goetze, G. Sklerotherapie bei Erkrankungen im HNO-Bereich. HNO 56, 349–360 (2008). https://doi.org/10.1007/s00106-008-1669-2

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