Management of Adult Hypopharyngeal Vascular Anomalies-A Descriptive Study

Objective: Given the rarity of adult hypopharyngeal vascular anomalies (AHVAs), no systematic studies are currently available. The aim of this study is to explore therapeutic strategies for AHVAs and determine the optimal timing for surgery in their treatment. Methods: We conducted a retrospective analysis of the data from patients diagnosed with AHVAs who underwent treatment using either bleomycin injection or excision methods in our department between September 2013 and November 2022. The study evaluated the curative efficacy, factors influencing efficacy, the size of AHVAs, and the selection of surgical methods. Results: A total of 23 adult patients underwent 30 distinct procedures. The study revealed that the choice of surgical methods significantly impacted therapeutic outcomes, with potassium-titanyl-phosphate laser, carbon dioxide (CO₂) lasers, low-temperature plasma, and Holmium laser proving effective in treating AHVAs. The therapeutic effect was found to be worse for AHVAs involving multiple subzones compared to those with single subzone invasion. Notably, 3 patients underwent 2 surgeries: the first involved a bleomycin injection, followed by a complete surgical excision. Conclusions: The findings of our study emphasize the superior outcomes achieved through surgical excision when AHVAs are clearly delineated. Furthermore, we recommend opting for surgical excision after a reduction of AHVAs induced by bleomycin injection.