Incidence and Factors Associated With Spontaneous Regression in Head and Neck Lymphatic Malformations

作者：Juliana Bonilla‐Velez, Carrie L. Heike, Larry G. Kessler, Xing Wang, Tara Wenger, Bonnie W. Ramsey, Jonathan A. Perkins · 发表于：JAMA Otolaryngology–Head & Neck Surgery · 年份：2025 · DOI：10.1001/jamaoto.2025.0104 · 被引用次数：3 · 研究领域：Vascular Malformations and Hemangiomas、Lymphatic Disorders and Treatments、Head and Neck Anomalies

Importance: Head and neck lymphatic malformations (HNLMs) demonstrate considerable variability in their natural history. While some malformations cause chronic severe functional impairment, others are asymptomatic and spontaneously regress. Understanding the frequency and features associated with regression will aid clinicians and families in making informed treatment choices and avoid unnecessary risks of intervention for a subset of patients. Objective: To assess the incidence, timing, and factors associated with spontaneous regression of HNLMs. Design, Setting, and Participants: This retrospective cohort study across a single regional pediatric tertiary care academic center included patients aged 0 to 21 years with HNLM who were evaluated in the vascular anomalies clinic and prospectively enrolled in an institutional quality improvement database between 2003 and 2022. Observation was offered to patients without symptoms or functional compromise. Treatment decisions were made during routine clinical care. Exposures: Age of HNLM onset and HNLM location, distribution, cystic structure, grade, and de Serres staging. Main Outcome and Measures: The incidence of complete spontaneous regression was estimated. The strength of the association between exposures and regression was assessed using risk ratios, Cliff Δ, and Cramer V. A Kaplan-Meier curve was used to estimate the probability of spontaneous regression over time. The association of the exposures on the likelihood of spontan...