A Case of Laryngeal Venous Malformation Successfully Treated with Keishibukuryogan and Daiokanzoto

Abstract

Laryngeal venous malformation has a risk of airway obstruction due to its enlargement or bleeding. It requires treatment such as sclerotherapy, laser treatment or surgery. However, adult-type laryngeal venous malformation occurs frequently in the upper part of the glottis, and causes almost no symptoms except when it occurs in the vocal cords. So some patients do not wish to undergo surgery. This time, we describe a case of an asymptomatic laryngeal venous malformation patient who did not wish to receive laser treatment, and was significantly improved by Kampo medicine. The patient was a 69-year-old man. He consulted us because of an accidental laryngeal mass on upper gastrointestinal endoscopy during a medical examination, but he had no particular pharyngeal symptoms. A venous malformation was found in the upper part of the right glottis, and we recommended him laser treatment. But he did not wish it because he had no symptoms. We considered the condition of static blood (oketsu), and administered keishibukuryogan for 7 weeks, but there was no change. Since he had constipation, we administered daiokanzoto together with keishibukuryogan, and his bowel movement improved. Thirteen weeks after the beginning of the combined use, the venous malformation also remarkably reduced.