Superselective embolization and transoral ultrasonic surgery of laryngeal hemangioma: a case report

Adult laryngeal hemangioma (LH) is a rare and slowly progressing vascular tumor. The optimal treatment is not yet well-established but can include conservative approaches, especially for asymptomatic cases, or surgical intervention. We report a rare case of an adult LH located in the supraglottis, causing hoarseness, throat foreign body sensation, and mild dyspnea. The large mass was initially embolized by injecting Spongostan and then resected using a transoral approach with an ultrasonic scalpel. After the excision, the patient quickly improved the voice function, and video laryngoscopy revealed reduced arytenoid mucosal swelling with a good movement of the arytenoid cartilages. No recurrence was observed 12 months after resection. After excision of LH, a close monitoring of the patient is essential because secondary hemorrhage may occur. Regular follow-up controls are needed to monitor the treatment response and to detect any recurrences. Surgical reduction of large LH, achievable by embolization and complete surgical resection with an ultrasonic scalpel, may represent an optimal surgical approach.