ENT Institute, Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Fenyang Road Num83, Xuhui District, Shanghai City, 200031, China.
Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai, 200031, China.
Eur Arch Otorhinolaryngol. 2023 Sep;280(9):4155-4163. doi: 10.1007/s00405-023-08024-7. Epub 2023 Jun 1.
To investigate the clinical outcomes of morphology-guided surgical treatment for adult laryngeal and hypopharyngeal hemangioma.
Patients diagnosed with adult laryngeal and hypopharyngeal hemangioma by outpatient laryngoscopy and received surgical treatments were retrospectively included. Size and morphology were classified to guide the choose of surgical procedures including CO laser excision, CO coagulation + bleomycin injection and potassium-titanyl-phosphate (KTP) laser + bleomycin injection. The baseline information and pre-, postoperative laryngoscopies were collected, the outcomes were followed up and analyzed.
A total of 68 patients were included, 7 cases with exophytic and non-bulky hemangioma received CO laser excision, 20 cases received CO laser coagulation + bleomycin injection and 25 cases with KTP + bleomycin injection, another 16 cases with pure bleomycin injection were included as comparison. There was no difference of baseline analysis among the groups (P > = 0.05). Positive outcomes were achieved in most cases of CO excision (100%), CO coagulation + bleomycin (90.0%) and KTP + bleomycin (84.0%) groups, which were better than pure bleomycin (56.3%, p = 0.001). CO2 or KTP, associated to Bleomycin, gave same results on same lesions (P = 0.132).
Morphology of hemangioma may help in the selection of surgical procedures. CO coagulation can be used as a potential substitute for KTP in the treatment of adult laryngeal and hypopharyngeal hemangioma.
探讨形态学指导下手术治疗成人喉及下咽血管瘤的临床疗效。
回顾性分析经门诊喉镜诊断为成人喉及下咽血管瘤并接受手术治疗的患者。根据大小和形态分类,指导选择手术方法,包括 CO2 激光切除、CO2 激光凝固+平阳霉素注射和 KTP 激光+平阳霉素注射。收集患者的基本信息和术前、术后喉镜检查结果,随访并分析疗效。
共纳入 68 例患者,7 例外生性非巨大型血管瘤患者接受 CO2 激光切除,20 例行 CO2 激光凝固+平阳霉素注射,25 例行 KTP 激光+平阳霉素注射,16 例单纯平阳霉素注射作为对照。各组间基线资料比较差异无统计学意义(P>0.05)。CO2 激光切除组(100%)、CO2 激光凝固+平阳霉素注射组(90.0%)和 KTP 激光+平阳霉素注射组(84.0%)的疗效均优于单纯平阳霉素注射组(56.3%,P=0.001)。CO2 激光或 KTP 联合平阳霉素治疗相同病变的疗效相同(P=0.132)。
血管瘤的形态学特征有助于选择手术方式。CO2 激光凝固可作为治疗成人喉及下咽血管瘤的 KTP 激光的替代方法。