EFFICACY OF INTRALESIONAL BLEOMYCIN SCLEROTHERAPY INJECTION IN CHILDREN WITH CYSTIC HYGROMA

Abstract

Objective: This study aimed to evaluate the efficacy of intralesional bleomycin sclerotherapy as a treatment for cystic hygroma in children, focusing on its ability to achieve complete resolution of the condition while assessing associated side effects. Methodology: A quasi-experimental study was conducted at the Department of Pediatric Surgery, Lady Reading Hospital, Peshawar from [06-July-2024 to 06-January-2025]. Ninety-seven children aged 1 to 8 years with clinically diagnosed cystic hygroma in the cervico-facial region were enrolled using consecutive non-probability sampling. Exclusion criteria included arteriovenous malformations and thoracic or abdominal lymphangiomas. After obtaining informed consent, each participant received intralesional bleomycin sclerotherapy under sedation with oral chloral hydrate (25 mg/kg). Bleomycin (0.5 mg/kg), diluted in 10–15 cc of distilled water, was injected into the cyst following fluid aspiration, with the procedure overseen by an experienced consultant. Efficacy, defined as complete cyst disappearance after three weeks, was assessed clinically. Results: Of the 97 participants (mean age 4.80 ± 2.183 years), Sixty (61.9%) were male and 37 (38.1%) female. Complete resolution occurred in 82 children (84.5%), while 15 (15.5%) showed no such outcome. Side effects were minimal, with 87 (89.7%) experiencing none, 6 (6.2%) reporting skin discoloration, and 4 (4.1%) developing residual fibrotic nodules. Statistical analysis revealed no significant influence of age, gender, BMI or socioeconomic factors on efficacy. Conclusion: Intralesional bleomycin sclerotherapy proved highly effective and safe, achieving an 84.5% complete resolution rate with few complications, supporting its use as a primary treatment for pediatric cystic hygroma. These findings advocate for its broader application in clinical practice.