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[Postcricoid vascular lesion in an infant]
Dan Sternbach1, Gadi Fishman, Liat Ben-Sira
1Pediatric Otolaryngology Unit, Department of Otolaryngology Head and Neck Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
A rare postcricoid vascular lesion in infants typically presents with feeding difficulties. While some cases resolve spontaneously, others require intervention, highlighting the need for accurate diagnosis and tailored treatment strategies.
Area of Science:
- Pediatric Otolaryngology
- Vascular Malformations
- Pediatric Surgery
Background:
- Postcricoid vascular lesions are rare congenital anomalies affecting infants.
- These lesions can cause significant respiratory and feeding issues.
- Literature review identified 19 pediatric cases, with varying clinical presentations and outcomes.
Observation:
- A 7-month-old female infant presented with coughing during feeding.
- Flexible laryngoscopy revealed a dynamic, bluish postcricoid mass.
- The lesion appeared with crying/straining and disappeared with relaxation.
Findings:
- Initial steroid treatment showed no effect on the lesion.
- The vascular malformation spontaneously resolved by 18 months of age.
- Literature review indicated 7/19 children improved without treatment, while 8 had comorbidities.
Implications:
- Postcricoid vascular lesions require a thorough diagnostic workup, including flexible laryngoscopy and videofluoroscopy.
- Management strategies range from observation to surgical intervention, depending on symptom severity.
- This case underscores the potential for spontaneous resolution in some pediatric postcricoid vascular lesions.
Abstract:
A 7-months-old female presented with coughing spells while feeding. Flexible laryngoscopy revealed a round bluish mass, emanating from the postcricoid area when the child cried or strained and disappeared when she relaxed. She was treated with systemic steroids for a month and was doing well. There was no change in the lesion. On examination at age 18 months the lesion disappeared. In a review of the literature, the authors found 6 articles describing 19 children with postcricoid vascular lesions. Seven children did not have significant related problems and did well without any treatment. Eight cases had significant co-morbidity. Treatment for symptomatic children included systemic or intralesion steroids, laser ablation and open resection. Postcricoid vascular lesion is a rare entity with a typical appearance. The recommended workup includes flexible laryngoscopy and videofluoroscopy. There are several treatment options for symptomatic children.
