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Infantile Hemangiomas of the Lip: Complications and Need for Surgical Intervention

BACKGROUND: Infantile lip hemangiomas are challenging to manage due to the functional and aesthetic importance of the lips. Hemangiomas in this region may lead to significant complications including ulceration, feeding difficulties, and lip contour distortion requiring surgical intervention. METHODS...

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Autores principales: Cawthorn, Thomas R., Fraulin, Frankie O.G., Harrop, Alan Robertson
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635212/
https://www.ncbi.nlm.nih.gov/pubmed/31624693
http://dx.doi.org/10.1097/GOX.0000000000002308
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author Cawthorn, Thomas R.
Fraulin, Frankie O.G.
Harrop, Alan Robertson
author_facet Cawthorn, Thomas R.
Fraulin, Frankie O.G.
Harrop, Alan Robertson
author_sort Cawthorn, Thomas R.
collection PubMed
description BACKGROUND: Infantile lip hemangiomas are challenging to manage due to the functional and aesthetic importance of the lips. Hemangiomas in this region may lead to significant complications including ulceration, feeding difficulties, and lip contour distortion requiring surgical intervention. METHODS: A retrospective chart review of children with focal lip hemangiomas treated at our institution between January 2000 and December 2016 was conducted. Patient demographics, lesion characteristics, complications, treatments, and outcomes were collected. Lesions were classified based on depth (superficial, deep, or mixed depth), vermillion border involvement, and location. RESULTS: One hundred and two patients with focal lip hemangiomas were identified; 45.1% were managed expectantly, 43.1% were treated medically, and 18.6% required surgery. Residual lip contour deformity following involution was the most common complication (26.5% of patients). Ulceration during the proliferation phase was reported in 14.7% of patients, leading to significant feeding difficulties in 9.8% of patients. All ulcerations occurred in lesions with a superficial component. None of the patients with superficial lesions underwent surgery; 27.1% of patients with deep or mixed depth hemangiomas required surgical treatment to restore lip contour. CONCLUSIONS: Lip hemangiomas have high rates of complications that seem to be related to lesion morphology and phase of growth. Ulceration occurs during the early proliferative phase and is most frequently associated with mixed depth hemangiomas. Residual lip contour deformities are identified in the involution phase; presence of a deep component is the primary factor in predicting the need for surgical intervention in these patients.
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spelling pubmed-66352122019-10-17 Infantile Hemangiomas of the Lip: Complications and Need for Surgical Intervention Cawthorn, Thomas R. Fraulin, Frankie O.G. Harrop, Alan Robertson Plast Reconstr Surg Glob Open Original Article BACKGROUND: Infantile lip hemangiomas are challenging to manage due to the functional and aesthetic importance of the lips. Hemangiomas in this region may lead to significant complications including ulceration, feeding difficulties, and lip contour distortion requiring surgical intervention. METHODS: A retrospective chart review of children with focal lip hemangiomas treated at our institution between January 2000 and December 2016 was conducted. Patient demographics, lesion characteristics, complications, treatments, and outcomes were collected. Lesions were classified based on depth (superficial, deep, or mixed depth), vermillion border involvement, and location. RESULTS: One hundred and two patients with focal lip hemangiomas were identified; 45.1% were managed expectantly, 43.1% were treated medically, and 18.6% required surgery. Residual lip contour deformity following involution was the most common complication (26.5% of patients). Ulceration during the proliferation phase was reported in 14.7% of patients, leading to significant feeding difficulties in 9.8% of patients. All ulcerations occurred in lesions with a superficial component. None of the patients with superficial lesions underwent surgery; 27.1% of patients with deep or mixed depth hemangiomas required surgical treatment to restore lip contour. CONCLUSIONS: Lip hemangiomas have high rates of complications that seem to be related to lesion morphology and phase of growth. Ulceration occurs during the early proliferative phase and is most frequently associated with mixed depth hemangiomas. Residual lip contour deformities are identified in the involution phase; presence of a deep component is the primary factor in predicting the need for surgical intervention in these patients. Wolters Kluwer Health 2019-06-19 /pmc/articles/PMC6635212/ /pubmed/31624693 http://dx.doi.org/10.1097/GOX.0000000000002308 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Article
Cawthorn, Thomas R.
Fraulin, Frankie O.G.
Harrop, Alan Robertson
Infantile Hemangiomas of the Lip: Complications and Need for Surgical Intervention
title Infantile Hemangiomas of the Lip: Complications and Need for Surgical Intervention
title_full Infantile Hemangiomas of the Lip: Complications and Need for Surgical Intervention
title_fullStr Infantile Hemangiomas of the Lip: Complications and Need for Surgical Intervention
title_full_unstemmed Infantile Hemangiomas of the Lip: Complications and Need for Surgical Intervention
title_short Infantile Hemangiomas of the Lip: Complications and Need for Surgical Intervention
title_sort infantile hemangiomas of the lip: complications and need for surgical intervention
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635212/
https://www.ncbi.nlm.nih.gov/pubmed/31624693
http://dx.doi.org/10.1097/GOX.0000000000002308
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