Unit of Otorhinolaryngology, Department on Neuroscience, 9307Federico II University Hospital, Naples, Italy.
Department of Advanced Biomedical Sciences, 9307Federico II University Hospital, Naples, Italy.
Ear Nose Throat J. 2022 Jun;101(5):326-331. doi: 10.1177/0145561320952191. Epub 2020 Sep 13.
The hemangioma is the most common vascular tumor, involving the head and neck in 60% of cases. It is rare in the larynx. In children, hemangiomas are more frequent on the subglottis, whereas in adults the most common site is the supraglottis. Laryngeal hemangioma with cavernous features isolated to the free edge of the vocal fold is a very rare clinical finding. We present 2 cases of glottic hemangioma. Both patients reported severe hoarseness.
In the first patient, an extensive blue-purple mass was seen on the right vocal cord. The patient was posted for microlaryngeal surgery with carbon dioxide (CO) laser. Second patient had a large, smooth, flesh-colored polypoid mass emanating from the left vocal cord. The patient was posted for microlaryngeal surgery. After 2 months, both patients showed a considerable voice improvement.
Vocal cord hemangiomas are very rare, and they usually cause problem in the voice of the patient. A vascular lesion that may mimic a hemangioma may sometimes result from an organizing hematoma following a hemorrhage on the vocal cords due to voice abuse. Laryngeal hemangiomas also need to be distinguished pathologically from polypoidal vascular granulation tissue that may be produced by laryngeal biopsy, intubation, or trauma. Indirect endoscopy is enough to diagnosis. No active treatment is advised for adult laryngeal hemangiomas unless the lesions are symptomatic or show a tendency to involve other parts. There is no uniformly accepted treatment of head and neck hemangiomas. Surgical excision with laser CO microlaryngoscopic techniques gives satisfactory results.
血管瘤是最常见的血管肿瘤，60%的病例发生在头颈部。喉部血管瘤较为少见。在儿童中，血管瘤更多见于声门下区，而在成人中，最常见的部位是声门上区。孤立于声带游离缘的具有海绵状特征的喉部血管瘤是一种非常罕见的临床发现。我们报告了 2 例声门血管瘤。这 2 例患者均表现为严重的声音嘶哑。
在第一例患者中，右侧声带可见广泛的蓝紫色肿块。该患者被安排行二氧化碳（CO）激光显微喉镜手术。第二例患者左侧声带可见一个大的、光滑的、肉色息肉状肿块。该患者被安排行显微喉镜手术。2 个月后，这 2 例患者的声音均有明显改善。
声带血管瘤非常罕见，通常会导致患者声音出现问题。有时，由于滥用嗓音，声带出血后可能会形成一个类似于血管瘤的血管性病变，也可能导致声带出现这种情况。喉部血管瘤还需要与由于喉活检、插管或创伤而产生的息肉样血管肉芽组织病变在病理上进行区分。间接喉镜检查足以诊断。除非病变有症状或有累及其他部位的趋势，否则不建议对成人喉部血管瘤进行积极治疗。头颈部血管瘤没有统一的治疗方法。激光 CO 显微喉镜下切除手术可获得满意的效果。
