Citation Information :
Mino-Oka A, Matsuda R, Shioyasono R, Ashtar M, Yasue A, Moriyama K. A Long-term Follow-up of Mandibular Deviation Caused by Congenital Cervical Lymphangioma Treated with an Orthodontic Approach. J Contemp Dent Pract 2021; 22 (6):713-720.
Aim: To report a treatment case of mandibular deviation caused by congenital cervical lymphangioma with traditional orthodontic techniques, following-up by 10-year retention.
Background: Lymphangiomas, developmental anomalies, can induce various disturbances of swallowing, mastication, speech, breathing, and skeletal deformities as well as psychological stress and anxiety for the patient and their family. Lymphangiomas are benign with virtually no possibility of turning into a malignant lesion, so clinical management aims to treat the patient functionally.
Case description: A girl, aged 6 years and 4 months, complained about facial asymmetry and anterior crossbite caused by congenital cervical lymphangioma. Her facial profile was the straight type with an adequate lip position. Anterior and right-side posterior crossbites were observed. On the frontal cephalogram, the menton shifted 3.0 mm to the right. A functional appliance with an expander was placed to correct her dental midline deviation and posterior crossbite. After 2-year treatment, the anterior and right-side posterior crossbites were improved. Multibracket treatment began after the growth spurt. After 44-month active treatment, a functional occlusion, including a Class I molar relationship with a proper interincisal relationship, was achieved. A functional occlusion was maintained during a 10-year retention period, while a mandibular downward growth was observed through the retention period.
Conclusion: Conventional orthodontic techniques enable functional and stable occlusion even in patients with mandibular deviation caused by congenital cervical lymphangioma, although only using early orthodontic management by itself may have some limitations.
Clinical significance: The hybrid technique combining functional appliance and intermaxillary elastics proves to be an effective therapy for correcting occlusal cant and mandibular deviation caused by cervical lymphangioma.
Grasso DL, Pelizzo G, Zocconi E, et al. Lymphangiomas of the head and neck in children. Acta Otorhinolaryngol Ital 2008;28(1):17–20.
Perkins JA. New frontiers in our understanding of lymphatic malformations of the head and neck: natural history and basic research. Otolaryngol Clin North Am 2018;51(1):147–158. DOI: 10.1016/j.otc.2017.09.002.
Sun RW, Tuchin VV, Zharov VP, et al. Current status, pitfalls and future directions in the diagnosis and therapy of lymphatic malformation. J Biophoton 2018;11(8):e201700124. DOI: 10.1002/jbio.201700124.
Wiegand S, Eivazi B, Barth PJ, et al. Pathogenesis of lymphangiomas. Virchows Arch 2008;453(1):1–8. DOI: 10.1007/s00428-008-0611-z.
Chung CJ, Hwang S, Choi YJ, et al. Treatment of skeletal open-bite malocclusion with lymphangioma of the tongue. Am J Orthod Dentofacial Orthop 2012;141(5):627–640. DOI: 10.1016/j.ajodo.2010.07.029.
Souki BQ, Figueiredo DS, Lima IL, et al. Two-phase orthodontic treatment of a complex malocclusion: giving up efficiency in favor of effectiveness, quality of life, and functional rehabilitation? Am J Orthod Dentofacial Orthop 2013;143(4):547–558. DOI: 10.1016/j.ajodo.2012.02.027.
Farronato M, Fama A, Lanteri V, et al. Lymphangioma of the tongue associated with open bite: case report. Eur J Pediatr Dent 2019;20(4):311–314. DOI: 10.23804/ejpd.2019.20.04.10.
Wada K, Matsushita K, Shimazaki S, et al. An evaluation of a new case analysis of a lateral cephalometric roentgenogram. J Kanazawa Med Univ 1981;6:60–70.
Guruprasad Y, Chauhan DS. Cervical cystic hygroma. J Maxillofac Oral Surg 2012;11(3):333–336. DOI: 10.1007/s12663-010-0149-x.
Toranzo JM, Guerrero F, Dibildox J, et al. A congenital neck mass. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82(4):363–364. DOI: 10.1016/s1079-2104(96)80298-8.
Hamoir M, Renacle M, Youssif A, et al. Surgical management of parapharyngeal cystic hygroma causing sudden airway obstruction. Head Neck Surg 1988;10(6):406–410. DOI: 10.1002/hed.2890100608.
Rubenduz M, Uslu O. Functional treatment of an asymmetry case having left side paralysis: a case report. Eur J Dent 2010;4(3):341–347.
Graber TM. Treatment of class III malocclusions. In: Graber TM, Rakosi T, Petrovic AG, editors. Dentofacial orthopedics with functional appliances. 2nd ed. St. Louis: Mosby; 1997. p. 461–480.
Ito A, Tachiki K, Shioyasono R, et al. Management of hemifacial microsomia caused by the first and second branchial arch syndrome with orthodontic approach. J Contemp Dent Pract 2020;21(10):1189–1195. PMID: 33686045.
Yamada H, Sawada M, Tanaka E. A case report of hemifacial mircosomia treated with conventional orthodontic technique: a long-term follow-up. J Am Dent Assoc 2021:S0002-8177(20)30782-0. DOI: 10.1016/j.adaj.2020.10.015.