2013 Volume 64 Issue 3 Pages 212-218
The majority of vascular anomalies which arise in the head and neck regions in adults are venous malformations (VMs). In this study, we performed a 5-year retrospective review in our department to evaluate the efficacy of potassium titanyl phosphate (KTP) laser surgery for hypopharyngolaryngeal VMs. Eight patients who had undergone laryngoscopic KTP laser surgery under general anesthesia were enrolled. There were 7 males and 1 female, the mean age at first treatment was 63.8 years, 4 cases were in the larynx and 4 in the hypopharynx, and the mean longest diameter of the pathological region on an image was 16.3 mm. Patients were treated by resection (3 cases) or photocoagulation (5 cases) ; subsequently, only one of the photocoagulated cases has recurred, two years later, and it was re-treated by resection. The resection therapy, due to its features regarding dissection and hemostasis, tended to be carried out when the pathological regions were smaller or could be reached by rigid laryngoscope. On the other hand, photocoagulation therapy was useful given its feature of preferential absorption by hemoglobin, which resulted in a lower risk of operative hemorrhage;hence, it can be used for palliative treatment for extremely large VMs that are impossible to remove. Because neither postoperative hemorrhage nor severe edema in the surgical field occurred, no patient required emergency airway treatment such as endotracheal intubation or tracheostomy. KTP laser surgery is a feasible and relatively safe treatment for hypopharyngolaryngeal VMs in adults.
