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  • 1
    Online Resource
    Online Resource
    Head and Neck Lymphatic Malformation Management Algorithm: An Experience from a Tertiary Centre in Tanzania
    Zambia Medical Association ; 2021
    In:  Medical Journal of Zambia Vol. 48, No. 2 ( 2021-08-10), p. 114-118
    Details
    In: Medical Journal of Zambia, Zambia Medical Association, Vol. 48, No. 2 ( 2021-08-10), p. 114-118
    Abstract: Background: Lymphatic malformations are localized areas of malformed lymphatic system that can either be congenital or acquired which commonly occur in the head and neck region. Several treatment options for lymphatic malformations have been proposed, despite this, there is no consensus as to optimal management. Objective: To determine the pattern and management of head and neck lymphatic malformations in a tertiary health facility in Tanzania. Material and Methods: This was a one-year crosssectional study that involved patients with head and neck lymphatic malformations treated in Muhimbili National Hospital. A structured questionnaire was used to collect information including age and sex ofthe patient, chief complaint and, duration, size and site of the lesion. The treatment modalities were surgery and/or intralesional bleomycin injection (IL-Bleo) using a locally developed algorithm. A standard dose of bleomycin was 0.3 to 0.6 mg/kg per injection not exceeding 15 units per cycle with a maximum of 6 cycles. Results: a total of 33 patients were included in the study. Males were 21 (63.6%) and the male to female ratio was 1.8:1. The age of patients ranged from 5 months to 28 years with a median age of 6 years. In 29 (87.9%) patients, the lesions were evident during birth. The median area covered by the lesion in 2 patients was 12.00 cm . Nine (27.3%) patients were managed by surgery alone, while majority (24, 72.7%) were given intralesional bleomycin (ILBleo), of whom majority (20, 83.3%) required surgical intervention subsequently. The overall outcome of management of patients was considered successful in 87% of patients. Conclusion: Head and neck lymphatic malformations are more common in males. Most of the lymphangiomas are of congenital type. Combining IL-Bleo and surgery an effective way of managing head and neck lymphatic malformations.
    Type of Medium: Online Resource
    ISSN: 0047-651X , 0047-651X
    URL: Article
    DOI: 10.55320/mjz.48.2.876
    Language: Unknown
    Publisher: Zambia Medical Association
    Publication Date: 2021
    detail.hit.zdb_id: 2538342-5
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  • 2
    Online Resource
    Online Resource
    Table_1.DOCX
    Frontiers Media SA ; 2023
    In:  Frontiers in Medicine Vol. 9 ( 2023-1-10)
    Details
    In: Frontiers in Medicine, Frontiers Media SA, Vol. 9 ( 2023-1-10)
    Abstract: The aim of this project is the sustainable implementation of a vascular anomalies (VA) program in Tanzania. Materials and methods In 2021 the first interdisciplinary VA program was initiated at Muhimbili National Hospital (MNH), Dar Es Salaam, Tanzania in a stepwise approach. During the planning phase the clinical need for minimally-invasive therapies of VAs and the preexisting structures were assessed by the local Interventional Radiology (IR) team at MNH. During the initiation phase, an IR team from two German VA centers joined the interdisciplinary team at MNH for clinical workup, image-guided procedures and follow-up. VA patients were recruited from existing patient records or seen at clinics as de novo presentations following nationwide advertisement. In the post-processing phase joined online conferences for follow-up and support in management of new patients were established. Further follow-up was supported by attending providers from other established VA centers, traveling to bolster the primary operators of MNH. Results The first interdisciplinary VA program was successfully launched in Tanzania. Minimally-invasive treatments were successfully trained, by performing ultrasound-guided sclerotherapy with polidocanol and bleomycin in twelve patients with slow-flow malformations, one endovascular embolization of a high-flow malformation, and medical treatment of an aggressive infantile hemangioma. Regular online follow-up presentations have been initiated. Follow-up evaluation and required treatment was sustained when appropriate. Conclusion The presented “hands-on” training set the ground for the first interdisciplinary VA program in Tanzania. This framework is expected to establish comprehensive and sustainable care of patients with VAs in East Africa and can serve as a blueprint for other sites.
    Type of Medium: Online Resource
    ISSN: 2296-858X
    URL: Article
    URL: Article
    DOI: 10.3389/fmed.2022.1056539
    DOI: 10.3389/fmed.2022.1056539.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2775999-4
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Head and Neck Lymphatic Malformation Management Algorithm: An Experience from a Tertiary Centre in Tanzania
    Zambia Medical Association ; 2021
    In:  Medical Journal of Zambia Vol. 48, No. 2 ( 2021-08-13), p. 114-118
    Details
    In: Medical Journal of Zambia, Zambia Medical Association, Vol. 48, No. 2 ( 2021-08-13), p. 114-118
    Abstract: Background: Lymphatic malformations are localized areas of malformed lymphatic system that can either be congenital or acquired which commonly occur in the head and neck region. Several treatment options for lymphatic malformations have been proposed, despite this, there is no consensus as to optimal management.Objective: To determine the pattern and management of head and neck lymphatic malformations in a tertiary health facility in Tanzania.Material and Methods: This was a one-year crosssectional study that involved patients with head and neck lymphatic malformations  treated in Muhimbili National Hospital. A structured questionnaire was used to collect information including age and sex of the patient,  chief complaint and, duration, size and site of the lesion. The treatment modalities were surgery and/or intralesional bleomycin injection (IL-Bleo) using a locally developed algorithm. A standard dose of bleomycin was 0.3 to 0.6 mg/kg per injection not exceeding 15 units per cycle with a maximum of 6 cycles.Results: a total of 33 patients were included in the study. Males were 21 (63.6%) and the male to female ratio was 1.8:1. The age of patients ranged from 5 months to 28 years with a median age of 6 years. In 29 (87.9%) patients, the lesions were evident during birth. The median area covered by the lesion in patients was 12.00 cm2. Nine (27.3%) patients were managed by surgery alone, while majority (24, 72.7%) were given intralesional bleomycin (ILBleo), of whom majority (20, 83.3%) required surgical intervention subsequently. The overall outcome of management of patients was considered successful in 87% of patients.Conclusion: Head and neck lymphatic malformations are more common in males. Most of the lymphangiomas are of congenital type. Combining IL-Bleo and surgery an effective way of managing head and neck lymphatic malformations.
    Type of Medium: Online Resource
    ISSN: 0047-651X , 0047-651X
    URL: Issue
    URL: Article
    DOI: 10.55320/mjz.48.2
    DOI: 10.55320/mjz.48.2.37
    Language: Unknown
    Publisher: Zambia Medical Association
    Publication Date: 2021
    detail.hit.zdb_id: 2538342-5
    Location Call Number Limitation Availability
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Pattern and management outcomes of head and neck hemangiomas: a prospective study from Tanzania
    EDP Sciences ; 2021
    In:  Journal of Oral Medicine and Oral Surgery Vol. 27, No. 4 ( 2021), p. 53-
    Details
    In: Journal of Oral Medicine and Oral Surgery, EDP Sciences, Vol. 27, No. 4 ( 2021), p. 53-
    Abstract: Introduction: Hemangiomas arise from the proliferation of endothelial cells surrounding blood-filled cavities. They have a slightly higher female predilection and about 60–70% of them occur in the head and neck region. Various medical and surgical options are available for the treatment of hemangiomas. Aim : To determine the pattern and management outcomes of head and neck hemangiomas in Tanzania. Material and methods : This was a one-year prospective, cross-sectional study that involved all consecutive patients with head and neck hemangiomas treated in Muhimbili National Hospital. A structured questionnaire was used to collect information including age and sex of the patient, chief complaint and, duration, size and site of the lesion. The treatment modalities were surgery and/or intralesional bleomycin injection (IL-Bleo). A standard dose of bleomycin was 0.3 to 0.6 mg/kg per injection not exceeding 15 units per cycle with a maximum of 6 cycles. Frequency distribution and cross-tabulation were performed and association between variables was assessed by the Chi-square test, whereby the p -value was set at p 〈 0.05. Results: A total of 58 patients were included in the study. The male to female ratio was 1:1.4 and the median age was 6.15 years. Majority (74%) of the patients had infantile hemangioma. The most common presenting complaint of patients/guardians of the patients were facial disfigurement (94.8%), pain (32.8%) and ulceration (22.4%). The most frequently involved sites were the lips (55.2%) followed by the cheeks (37.9%). In patient who were managed surgically, there was a 100% reduction in size of the lesion. Of those who were treated with bleomycin, the percentage reduction in the area of the lesion ranged from 8.33% to 100% with mean of 72.6%. Only 6% of the patient had post IL-Bleo complications. Conclusion: Head and Neck hemangiomas are more common in females and majority are infantile hemangioma. Facial disfigurement is the commonest presenting complication of these lesions, and the lips and the cheeks are mostly affected areas. Intralesional bleomycin is an effective treatment modality which has low complication rates.
    Type of Medium: Online Resource
    ISSN: 2608-1326
    URL: Article
    DOI: 10.1051/mbcb/2021022
    Language: English
    Publisher: EDP Sciences
    Publication Date: 2021
    detail.hit.zdb_id: 3002794-9
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