Lymphaticovenular anastomosis for Morbihan disease: a case report

Hong, Jung Hyun; Yi, Changryul Claud; Lee, Jae Woo; Bae, Yong Chan; Kim, Ryuck Seong; Kim, Joo Hyoung

doi:.0..

Arch Craniofac Surg > Epub ahead of print

Case Report

DOI: https://doi.org/10.7181/acfs.2022.01067 [Epub ahead of print]
Published online April 27, 2023.

Lymphaticovenular anastomosis for Morbihan disease: a case report

Jung Hyun Hong¹

, Changryul Claud Yi¹

¹Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
²Biomedical Research Institute, Pusan National University Hospital, Busan, Korea

Correspondence: Joo Hyoung Kim,
Email: medic144@hanmail.net

Received: 22 November 2022 • Revised: 9 January 2023 • Accepted: 2 March 2023

Abstract

Morbihan disease (MD) is a very rare condition characterized by rosaceous or erythematous lymphedema on the upper twothirds of the face. A definitive management strategy for MD is lacking, and treatment is challenging. Herein, we present a case of persistent bilateral eyelid edema treated by lymphaticovenular anastomosis (LVA) and lymph node-vein bypass surgery. The patient experienced persistent bilateral eyelid edema. Indocyanine green lymphography was performed, and the diagnosis of bilateral facial lymphedema was confirmed. On the right side, a preauricular lymphatic vessel was anastomosed to a vein. On the left side, lymphostomy on the preauricular lymph node was done, with anastomosis to the transected proximal end of the concomitant vein of the transverse facial artery. Furthermore, a preauricular lymphatic vessel was anastomosed to a vein. Eyelid edema decreased and progressively improved on both sides. The outcome of this case suggests that LVA and lymph node-vein bypass surgery are appropriate for treating persistent eyelid edema related to MD.

Keywords: Case reports / Edema / Eyelids / Lymphedema / Therapeutics