Potassium-Titanyl-Phosphate (KTP) Laser Photocoagulation Combined with Resection Using an Ultrasonic Scalpel for Pharyngolaryngeal Hemangioma via a Transoral Approach: Case Report and Literature Review

Abstract

Patient: Male, 61-year-old

Final Diagnosis: Hemangioma

Symptoms: Foreign body sensation in the throat • throat clearing

Medication: —

Clinical Procedure: KTP laser photocoagulation combined with resection using an ultrasonic scalpel for pharyngolaryngeal hemangioma via a transoral approach

Specialty: Otolaryngology

Objective:

Unusual clinical course

Background:

Hemangiomas are relatively rare, slow-growing, benign neoplasms that can cause necrosis, ulceration, and infection leading to airway obstruction or intractable hemorrhage. Controversy persists regarding the treatment options for these tumors, which include active observation, corticosteroids, sclerotherapy, laser treatment, and surgical resection.

Case Report:

A 61-year-old man presented with a 6-month history of persistent throat clearing and foreign body sensation in the throat. He was receiving medical treatment and psychotherapy for major depressive disorder and anxiety disorder. Laryngoscopy and computed tomography revealed a large, irregular, lobulated mass covered by bluish mucosa in the hypopharynx and larynx on the right without involvement of the true vocal fold or subglottis. Orotracheal intubation was performed under general anesthesia. The hemangioma abutting the epiglottis and arytenoid was dissected by CO ₂ laser. The hemangioma in the pharyngoepiglottic fold and aryepiglottic fold was resected using an ultrasonic scalpel. The hemangioma in the ventricle, false vocal fold, and paraglottic space was treated by potassium-titanyl-phosphate (KTP) laser photocoagulation. Pathological examination confirmed hemangioma. There has been no recurrence during 18 months of follow-up.

Conclusions:

The treatment of pharyngolaryngeal hemangiomas is challenging. It is important to select treatment options considering the characteristics of the treatments and the anatomical and functional relationship between the hemangioma and the surrounding structures. Single-session KTP laser photocoagulation combined with surgical resection using an ultrasonic scalpel via a transoral approach according to anatomic site could be an effective treatment for pharyngolaryngeal hemangioma.