TRANSORAL EXCISION OF HEMANGIOMAS AND LYMPHANGIOMAS OF THE LIPS AND CHEEK | ||
| The Egyptian Journal of Surgery | ||
| Volume 19, Issue 3, July 2000, Pages 202-213 PDF (2.4 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2000.378593 | ||
| Authors | ||
| Mosaad Soliman* 1; Mohamed El Ghazaly2 | ||
| 1Vascular Surgery Unit, Mansoura University Hospital | ||
| 2Pediatric Surgery Unit, Mansoura University Hospital | ||
| Abstract | ||
| Hemangiomas and lymphangiomas are considered vascular malformations of either hamartomatous or neoplastic origin, that may involve arterial, venous, or lymphatic vessels. Hemangiomas and lymphangiomas constitute the largest group of tumors or tumor-like malformations in childhood with high prevalence in the periorbital region, the lips and cheek. Lesions of the lips and cheek represent a surgical challenge being related to important structures in addition to the risk of disfigurement following direct excision. Twenty five patients with hemangiomas and lymphangiomas of the lips and cheek were treated by transoral excision. The lesions affected the lower lip in 8 patients, the upper lip in 2 patients, the cheek in 11 patients, the cheek and extending to the upper lip in 2 patients and the angle of the mandible in 2 patients. Evertion of the lip or cheek and division of the gingivolabial sulcus, elevation of the buccal or labial mucosa, isolation of parotid duct and division of the buccinator muscle if needed. The whole lesion can be traced and excised even those reaching the lower eyelid. Complete excision of the lesion was feasible in 19 patients without residual swelling or discoloration. In patients with mixed hemangiomas, excision of the cavernous part was followed by fading of the capillary element within one year. In patients with cheek lesions, none had parotid duct or buccal nerve injury. One patient with ulcerated hemangioma of the lip had its ulcer remaining after disappearance of the swelling. Conclusions 1- This approach carried the least postoperative morbidity without scar on the skin. 2- Mixed hemangiomas should be treated by excision of the cavernous element only without increasing the risk of damaging the covering layer during excision of the capillary part as the later will fade by time. 3- Hemangiomas of the lip should not be treated conservatively as ulceration will compromise further surgical ablation. | ||
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