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Pediatric postcricoid vascular malformation: a diagnostic and treatment challenge
Karen B Zur1, Robert E Wood, Ravindhra G Elluru
1Cincinnati Children's Hospital Medical Center, Division of Pediatric Otolaryngology-Head and Neck Surgery, 3333 Burnet Avenue ML 2018, Cincinnati, OH 45229-3039, USA. karen.zur@cchmc.org
Insights
Pediatric postcricoid hemangiomas are rare, causing swallowing difficulty and stridor. Transoral laser therapy effectively treated these vascular malformations, resolving symptoms in young patients.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Vascular Malformations
Background:
- Hemangiomas in the upper aerodigestive tract are uncommon in children.
- Previous reports detail postcricoid hemangiomas causing dysphagia and respiratory distress.
Observation:
- Three children presented with swallowing difficulty and stridor due to occult postcricoid masses.
- Valsalva maneuvers aided in diagnosing these vascular malformations.
- Transoral laser therapy (KTP and CO2) was employed for lesion ablation.
Findings:
- All three pediatric patients achieved symptom resolution after laser therapy.
- Follow-up durations varied, with patients remaining symptom-free at 2 weeks, 5 months, and 5 years.
Implications:
- Highlights the diagnostic challenges of pediatric postcricoid hemangiomas.
- Demonstrates the efficacy of transoral laser ablation as a therapeutic option.
- Contributes to the limited literature on managing these rare pediatric airway lesions.
Abstract:
Hemangioma of the upper aerodigestive tract is a rarely reported occurrence in the pediatric literature. To date, there have been three published case reports of postcricoid hemangiomas contributing to unexplained dysphagia and respiratory distress. We present three children with a history of swallowing difficulty and stridor who were found to have an occult postcricoid mass. Valsalva maneuvers confirmed the suspicion of a vascular malformation in both patients. Transoral laser therapy (KTP and CO2) was used to ablate the lesions. The patients are symptom-free at 5 months, 5 years, and 2 weeks, respectively. The diagnostic challenge in evaluating these children and the therapeutic choices are described.
