Transoral ultrasonic surgery of pharyngolaryngeal giant hemangioma after ethylene-vinyl alcohol copolymer (Onyx) embolization.

Transoral ultrasonic surgery of pharyngolaryngeal giant hemangioma after ethylene-vinyl alcohol copolymer (Onyx) embolization.

Head Neck. 2017 Mar 06;:

Authors: Valls-Mateus M, Román LS, Macho J, Nadal A, Bernal-Sprekelsen M, Vilaseca I

Abstract
BACKGROUND: Cervico-mediastinal hemangiomas in adulthood are rare and slow-growing vascular tumors. The optimal treatment for giant hemangiomas is controversial. In asymptomatic cases, clinical observation is generally recommended.
METHODS: We report the transoral resection of a pharyngolaryngeal hemangioma (diameters of 44 × 56 × 39 mm) with tracheal involvement and mediastinal extension. Clinically, the patient had throat foreign body sensation, severe dyspnea and stridor. The hemangioma was first embolized by injecting ethylene-vinyl alcohol copolymer (Onyx) transorally, and then the obstructive aspect of the tumor was resected with a bipolar and ultrasonic clamp (ThunderBeat®, Olympus).
RESULTS: Two months after surgery, nasal fiberendoscopy showed complete disappearance of the vascular mass at the larynx and hypopharynx, with a normal mobility of the larynx.
CONCLUSION: In symptomatic patients, surgical reduction of large pharyngolaryngeal hemangiomas may be feasible by direct embolization and transoral ultrasonic resection. Both may provide an almost bloodless surgical field. © 2017 Wiley Periodicals, Inc. Head Neck, 2017.

PMID: 28263419 [PubMed - as supplied by publisher]

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