Journal of Pediatric Surgery Case Reports (Jul 2022)

Partial resection of a face and neck lymphatic malformation after tracheostomy: A case of difficult airway management

  • Daisuke Kuwata,
  • Takeshi Hirabayashi,
  • Takeshi Saito,
  • Daiki Kasai,
  • Kenichi Hakamada

Journal volume & issue
Vol. 82
p. 102305

Abstract

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Lymphatic malformation (LM) is a congenital abnormality of lymphatic vessel formation. When it occurs in the face and neck, airway management may be required. We describe a 1-month-old boy with a large LM of the face and neck. This case required airway management due to large lesions, and a tracheostomy needed to be performed. After the tracheostomy, the patient was troubled with frequent ventilation problems and developed a tracheal ulcer because of tracheostomy tube instability that occurred due to twisting of the trachea caused by the large lesions. Accordingly, we performed a partial resection of the LM, and the airway was stabilized. After partial resection, the patient was able to receive sclerotherapy and an m-TOR inhibitor as radical treatment. Based on this, we believe partial resection of an LM can be a viable option to stabilize airway management in cases of large lesions that cause airway constriction and tortuosity.

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