Bengal Journal of Otolaryngology and Head Neck Surgery (Dec 2016)
Intralesional Sclerotherapy with Polidocanol in the Management of Head and Neck Vascular Lesions
Abstract
Introduction Vascular lesions (Hemangioma or vascular malformation) in the head and neck region are quite common and need therapeutic intervention if they become symptomatic or cosmetically unacceptable. Different therapeutic modalities including cryotherapy, corticosteroids, laser therapy, sclerotherapy, surgery and/or embolization are available. Advances in laser surgery as well as sclerotherapy techniques have improved our ability to treat extensive lesions. Surgical excision sometimes becomes very difficult due to massive per-operative bleeding and proximity to major neurovascular structures. In this study we have tried to find a simpler, easily available, safe and cost-effective therapy to treat these vascular lesions. Materials and Method A pilot case study was conducted in a tertiary care hospital in Kolkata for a period of one year. Polidocanol was selected as the sclerosing agent for treatment of head and neck vascular lesions for its safety and its local anesthetic effect. 3% Polidocanol was injected in 20 lesions. Result 20 patients with head and neck vascular lesions treated with polidocanol sclerotherapy were followed up for 12 months. The study included 20 patients (12 female and 8 male) with mean age 20.3 years (range 6-62 years). Of these 20 patients 14 had 90% to 100% result and in 6 patients we obtained only mild improvement. Discussion Sclerotherapy is now becoming the first choice of treatment in head and neck vascular lesions. Polidocanol is a mixture of 5% ethyl alcohol and 95% hydroxypolyethoxydodecane, the detergent action of which induces a rapid overhydration of endothelial cells, leading to vascular injury and regression of vascular lesions. As the same time it is a local anesthetic, so treatment is painless. Conclusion It is a less invasive, cost effective, painless OPD based management for head and neck vascular lesions having good functional and aesthetic outcome.
