Se Jin Cho1, Jeong Hyun Lee2, Sae Rom Chung1, Young Jun Choi1, Jung Hwan Baek1. 1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea. 2. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea. Electronic address: jeonghlee@amc.seoul.kr.
Abstract
PURPOSE: To evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency (RF) ablation in the treatment of facial microcystic lymphatic malformations (mLMs) or mixed venolymphatic malformations (VLMs) and to introduce the "induced-paralysis" technique with the use of an injectable electrode to minimize neural complications. MATERIALS AND METHODS: Data from patients with symptomatic facial mLMs or mixed VLMs who underwent US-guided RF ablation in 2014-2017 were retrospectively reviewed. Computed tomography (CT) and/or magnetic resonance (MR) imaging was used to localize any functional structures close to the target lesion. Treatment outcome was assessed by 4-point cosmetic grading score (CGS). Treatment outcome was compared between patients with vs without a functional structure close to the lesion and those treated with a noninjectable vs an injectable electrode. Immediate and late complications were assessed during follow-up. RESULTS: Data from 15 patients were evaluated. Initial CGS and median volume were significantly decreased at the last follow-up in all patients (from 4 to 1 and from 7 mL to 0.7 mL, respectively; P < .05). Treatment outcome differed significantly between those with and without a functional structure on CT or MR imaging (P < .05) but showed no difference between noninjectable (n = 9) and injectable electrodes (n = 6). Two cases of transient cranial nerve palsy were seen in the noninjectable electrode group. CONCLUSIONS: US-guided RF ablation is effective in patients with facial mLMs or mixed VLMs. The induced-paralysis technique with an injectable electrode has the potential to ensure technical safety without compromising efficacy.
PURPOSE: To evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency (RF) ablation in the treatment of facial microcystic lymphatic malformations (mLMs) or mixed venolymphatic malformations (VLMs) and to introduce the "induced-paralysis" technique with the use of an injectable electrode to minimize neural complications. MATERIALS AND METHODS: Data from patients with symptomatic facial mLMs or mixed VLMs who underwent US-guided RF ablation in 2014-2017 were retrospectively reviewed. Computed tomography (CT) and/or magnetic resonance (MR) imaging was used to localize any functional structures close to the target lesion. Treatment outcome was assessed by 4-point cosmetic grading score (CGS). Treatment outcome was compared between patients with vs without a functional structure close to the lesion and those treated with a noninjectable vs an injectable electrode. Immediate and late complications were assessed during follow-up. RESULTS: Data from 15 patients were evaluated. Initial CGS and median volume were significantly decreased at the last follow-up in all patients (from 4 to 1 and from 7 mL to 0.7 mL, respectively; P < .05). Treatment outcome differed significantly between those with and without a functional structure on CT or MR imaging (P < .05) but showed no difference between noninjectable (n = 9) and injectable electrodes (n = 6). Two cases of transient cranial nerve palsy were seen in the noninjectable electrode group. CONCLUSIONS: US-guided RF ablation is effective in patients with facial mLMs or mixed VLMs. The induced-paralysis technique with an injectable electrode has the potential to ensure technical safety without compromising efficacy.