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[Hemangioma of the larynx in children]
Insights
Pediatric laryngeal hemangiomas, often presenting as hoarse voice in infants, can be treated with cryosurgery or may resolve spontaneously. Associated hemangiomas in other body areas may require radiotherapy.
Area of Science:
- Pediatric Otolaryngology
- Vascular Anomalies
- Pediatric Surgery
Background:
- Chronic laryngeal stenosis in children can stem from various etiologies.
- Laryngeal hemangiomas are a rare cause of airway obstruction in infants.
- Early diagnosis and intervention are crucial for managing pediatric airway compromise.
Observation:
- Out of 235 children with chronic laryngeal stenosis, 11 (4.6%) were diagnosed with laryngeal hemangiomas.
- The most common symptom was a hoarse voice, with affected children aged 5 months or younger.
- Five patients had associated hemangiomas in other body areas, frequently on the face, neck, or upper chest.
Findings:
- Laryngeal hemangiomas were predominantly located below the vocal folds (6 cases), with others on the gastric/aryepiglottic folds (4 cases) and vocal folds (1 case).
- Cryosurgery was the primary treatment, successfully decannulating 6 patients within 2-4 months.
- Radiotherapy was used for disseminated hemangiomas, leading to decannulation in 2 of 3 patients, though one developed a postradiation scar.
- Spontaneous resolution occurred in 2 children between 2 and 3 years of age.
Implications:
- Cryosurgery offers a minimally invasive and effective treatment for pediatric laryngeal hemangiomas.
- Radiotherapy may be considered for extensive hemangiomas but carries risks of complications like scarring.
- The potential for spontaneous regression highlights the importance of watchful waiting in select cases.
- Understanding the varied presentation and treatment outcomes aids in optimizing management strategies for these rare pediatric airway lesions.
Abstract:
Hemangiomas were diagnozed in 11 patients (4.6%) out of 235 children with chronic laryngeal stenoses of various etiology. The most frequent symptom was hoarse voice. The children examined were not older than 5 months. In 5 patients, laryngeal hemangiomas were associated with hemangiomas of other body compartments--most frequently on the skin of the face, neck or upper chest. Out of the 11 laryngeal hemangiomas 6 were located below vocal folds, 4 on gastric and aryepiglottic folds and only 1 on vocal folds. The first line method of treatment was cryosurgery. Local freezing was performed on 6 patients. They all were decannulated within 2 to 4 months after intervention. There children with disseminated hemangiomas of the face, neck and upper chest were exposed to radiotherapy. A year after, two of them were decannulated and the third one developed a postradiation scar below vocal cords. In 2 children when they were 2 or 3 years of age, laryngeal hemangiomas disappeared spontaneously without any treatment.