Postcricoid vascular abnormalities: hemangiomas, venous malformations, or anatomic variant.

Area of Science:

• Pediatric Otolaryngology
• Pediatric Airway Disorders
• Vascular Lesions

Background:

• Previously, pressure-dependent postcricoid masses (PDPCM) in children were often misdiagnosed as hemangiomas or vascular malformations.
• This series represents the largest to date investigating these specific pediatric airway lesions.

Purpose of the Study:

• To present ten pediatric cases of PDPCM, proposing they represent an anatomic variant.
• To review the presentation, diagnosis, and management of PDPCMs in the largest reported series.

Main Methods:

• Ten patients aged five weeks to nine months were diagnosed and managed through observation or intervention.
• Interventions included gastrostomy tube, fundoplication, Propranolol therapy, and tracheotomy for a patient with CHARGE association.

Main Results:

• No significant interval changes in size or appearance were observed in the PDPCMs.
• Eight out of ten patients experienced positive outcomes with observation alone.

Conclusions:

• The majority of PDPCMs are likely an anatomic variant, distinct from hemangiomas or vascular malformations.
• Awake flexible fiberoptic laryngoscopy is the primary diagnostic tool; direct laryngoscopy and bronchoscopy are recommended for symptomatic cases due to high incidence of synchronous airway pathology.
• Observation is the recommended management for most PDPCMs, as active treatment is often unnecessary.