Morphology-guided treatment of adult laryngeal and hypopharyngeal hemangioma: FD-EENT experience

Abstract

Objectives: To investigate the clinical outcomes of morphology-guided surgical treatment for adult laryngeal and hypopharyngeal hemangioma.

Materials and methods: Patients diagnosed with adult laryngeal and hypopharyngeal hemangioma by outpatient laryngoscopy and received surgical treatments were retrospectively included. Size and morphology were classified to guide the choose of surgical procedures including CO₂ laser excision, CO₂ coagulation + bleomycin injection and potassium-titanyl-phosphate (KTP) laser + bleomycin injection. The baseline information and pre-, postoperative laryngoscopies were collected, the outcomes were followed up and analyzed.

Results: A total of 68 patients were included, 7 cases with exophytic and non-bulky hemangioma received CO₂ laser excision, 20 cases received CO₂ laser coagulation + bleomycin injection and 25 cases with KTP + bleomycin injection, another 16 cases with pure bleomycin injection were included as comparison. There was no difference of baseline analysis among the groups (P > = 0.05). Positive outcomes were achieved in most cases of CO₂ excision (100%), CO₂ coagulation + bleomycin (90.0%) and KTP + bleomycin (84.0%) groups, which were better than pure bleomycin (56.3%, p = 0.001). CO2 or KTP, associated to Bleomycin, gave same results on same lesions (P = 0.132).

Conclusions and significance: Morphology of hemangioma may help in the selection of surgical procedures. CO₂ coagulation can be used as a potential substitute for KTP in the treatment of adult laryngeal and hypopharyngeal hemangioma.

Keywords: Carbon dioxide laser; Hemangioma; Hypopharynx; KTP; Larynx; Morphology.