Comparative Study on Efficacy of Intralesional Bleomycin Injection in Head and Neck Lymphangioma and Vascular Malformation MC04-MC06
Dr. Deepak Regmi,
Kathmandu Medical College,184, Baburam Acharya Sadak, Sinamangal, P.O. Box Number: 21266, Kathmandu, Nepal.
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 Studentís 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.