Abstract: Objective To investigate the clinical manifestations,imaging features,treatment strategies and outcome of head and neck lymphatic malformation (LM) in children.Methods The clinical data of 96 cases of head and neck LM confirmed by surgery or pathology from July 2014 to January 2022 were analyzed retrospectively.There were 2 cases of simple open surgery,10 cases of simple bleomycin injection,and 84 cases of open surgery combined with bleomycin.69 cases underwent one operation,15 cases underwent two operations,and 12 cases underwent three to eight operations.After admission,4 cases underwent endotracheal intubation and 3 cases underwent tracheotomy.Followed up for 3 ~ 93 months.Results There were 58 males and 38 females.The onset age ranged from 1 day to 14 years and 3 months,including 64 cases less than 2 years old,and 40 cases at birth.The lesions were located in 46 cases on the left,43 cases on the right and 7 cases on both sides;The lesions were located in the neck and parapharyngeal in 61 cases,in the head and face in 10 cases,and widely infiltrated in the head,face,neck or mediastinum in 25 cases;There were 91 cases of painless masses and 5 cases of inflammatory masses,including 28 cases of facial changes and 9 cases of dyspnea or dysphagia.There were 43 cases of intracapsular hemorrhage,and its contents were dark red or light bloody liquid.There were light yellow clear liquid or jelly like in 37 cases and water liquid in 16 cases.The positive rate of ultrasound diagnosis was 80.1% (70/87),and the positive rate of CT diagnosis was 91.8% (78/85).9 cases had transient facial paralysis,all returned to normal within 3 months,and 96 cases were cured.Conclusions Most of the head and neck LM occur within 2 years old.The clinical manifestation is often painless mass,mainly polycystic.The tumor body is often enlarged in a short time due to intracapsular hemorrhage.Ultrasound and CT reveal certain characteristic imaging findings,which can assist in diagnosis and treatment plan.Open surgery combined with bleomycin lavage will still be the main means of treatment in the future.

Key words: lymphatic malformation, head and neck, children, clinical manifestations, imaging features, treatment