The term ‘Cystic hygroma’ has been used in the past to describe congenital lymphatic malformations, usually presenting before the age of 2 years. The cervico-facial region is the most commonly involved anatomical location. Lymphovascular malformations involving the head and neck may present with cosmetic disfigurement, upper aerodigestive tract symptoms and/or recurrent infections. They are described as macrocystic or microcystic, although often a combination of both is present.
Microcystic disease can be difficult to treat and may necessitate repeated debuking procedures.
Macrocystic disease is usually treated with surgical excision and less commonly sclerotherapy.
Sclerosing agents can cause initial swelling before a reduction in size. Any surgery is aimed specifically at relieving symptoms, maintaining the airway and having minimal or no effect on function. Less frequently, tracheostomy and/or gastrostomy may be needed as part of a management strategy.