Diagnosis and surgical treatment of Madelung's disease / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To discuss t he diagnosis and surgical methods of the Madelung's disease. METHODS Detailed clinical data of 6 patients with Madelung's disease who was received surgical treatment in our department from January 2011 to November 2015 were reviewed. RESULTS All patients were male, aged from 35 to 65 years. The 6 patients had excessive subcutaneous fat deposit predominantly around the neck. One of the 6 patients had excessive fat deposit in larynx. All patients had history of heavy drinking. Two patients had the complication of cardiac disease, pulmonary disease and cerebral disease. One patient had the complication of glucose intolerance. Five patients were associated with sleep apnea syndrome. One patient came to hospital with dyspnea in emergency. All patients had received surgical treatment and abstinence from alcohol, 4 patients had the total neck lipectomy and tracheotomy. One patient had the total neck lipectomy with no tracheotomy. One patient had received emergency surgery-partial neck lipectomy and tracheotomy because the patient came to hospital with dyspnea in emergency. This case was referred to respiratory department without a second surgery for his severe complications and high surgical risk. This case discharged with tracheal tube. No obvious recurrence was seen during a follow-up of 15 days to 48 months. The pathological results were nonencapsulated fat. CONCLUSION Madelung's disease is a kind of benign disease arised from lipodystrophy which characterized by massive accumulation of nonencapsulated subcutaneous fat mainly located symmetrically in the fascial space of neck and shoulder. Most patients had heavy drinking history, chronic alcoholism may be a major risk factor. It may be associated with some complications. Total neck lipectomy has good effect. The aim of the operation is to improve outline appearance and function of the neck, which is good for patient's quality of life.