Effects and mechanism of OK-432 therapy in various neck cystic lesions

Abstract

Conclusion: Our results confirmed that OK-432 therapy is simple, easy, safe, and effective and can be used as a substitute for surgery in the treatment of benign neck cysts. In OK-432 therapy, inflammatory cytokines may play important roles in shrinkage of the cystic spaces. Objective: The aim of this study was to evaluate the outcome and mechanism of action of OK-432 therapy in benign neck cysts. Methods: We tried OK-432 therapy in 83 patients with benign neck cysts between April 1997 and August 2009. We aspirated as much of the fluid content of each cystic lesion as possible, and then replaced the volume of aspirated fluid with about half the volume of OK-432 solution. We evaluated the mechanism of action of OK-432 in 43 of the patients. The intracystic fluid in the cysts was aspirated before and after OK-432 therapy, and cytokine production in each aspirate was analyzed by ELISA. Results: Disappearance of the lesion was observed in 63 of 83 patients (76%). Marked reduction was observed in 13 of the 83 patients (16%). Partial reduction was observed in two patients (2%) and no response was seen in five (6%). Local discomfort at the injection site and low-grade fever were side effects observed in half of the patients, but such problems resolved within a few days. No local scarring or deformity of the injected sites occurred in any patient. We performed OK-432 therapy on an outpatient basis without hospitalization. Levels of various cytokines, including tumor necrosis factor, interleukin-8, interleukin-6, interferon gamma, and vascular endothelial growth factor, were significantly elevated in each aspirate after OK-42 therapy.

Keywords::

• Branchial cleft cyst
• thyroglossal duct cyst
• ranula
• OK-432
• cytokines

Acknowledgments

This study was supported by grants from the Ministry of Education, Science, Sports, and Culture (Grants-in-Aid for Scientific Research, C 19591955), Japan. This manuscript is dedicated to Professor Masaru Aoyagi, chairman, Department of Otolaryngology, Yamagata University, School of Medicine, who recently retired.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.