Persistent cavernous haemangioma of the larynx--a pregnancy problem

An unusual cause of dyspnea in a pregnant woman: supraglottic hemangioma

Dyspnea is a common complaint among pregnant women; upper airway obstruction is a rare cause of it. We report a case of supraglottic hemangioma in a 20-year-old pregnant woman who presented with increasing dyspnea and hoarseness at 40 weeks of gestation. She gave birth to a healthy 3,100-g girl by caesarean delivery under epidural anesthesia. She was able to breathe easily during the postpartum period. This case represents a rare instance of dyspnea caused by a supraglottic hemangioma in a pregnant woman.

Physiological changes in ENT during pregnancy

Although a number of changes occur in ear, nose, throat during pregnancy, yet these changes are neglected because majority of these changes go away after the pregnancy is over. Almost every corner of ENT is effected during pregnancy e.g., ear, nose, larynx (voice), oesophagus, thyroid etc. This paper deals with the various physiological changes in ENT during pregnancy and the worsening of symptomatology of various ENT ailments during pregnancy. These physiological changes are mainly due to the changing levels of estrogens and progesterone hormones during pregnancy. Many of these changes lead to symptomatology referable to head & neck and various disorders managed by otolaryngologist are more prevalent during pregnancy. A thorough understanding of these various effects of pregnancy is mandatory for an otolaryngologist to treat these disorders.

Adult laryngeal hemangioma CO2 laser excision. A single institution 3-year experience (Vittorio Veneto 2001-2003)

CONCLUSIONS

Adult supraglottic hemangiomas can be treated successfully with CO2 laser excision with limited morbidity. Extended laryngeal cavernous hemangiomas involving hypopharynx should be approached with staged CO2 laser surgical procedures.

OBJECTIVES

Hemangioma of the adult larynx is an uncommon, benign lesion characterized by thin, friable mucosa overlying the vascular stroma. The optimal surgical approach to these lesions is still controversial because only anecdotal case reports or very limited series are available. We report a 3-year, retrospective, single institution study of the results of CO2 laser treatment of supraglottic hemangiomas in adults.

PATIENTS AND METHODS

Six consecutive cases of adult laryngeal hemangioma were treated by the first author with CO2 laser microsurgery alone.

RESULTS

In five of six cases, no recurrences have been diagnosed (median follow-up period: 29 months). One case presented limited persistence of disease in the retro-cricoid and arytenoids at 20-month follow-up control.

Airway Obstruction Secondary to Rhinoscleroma during Pregnancy

Dyspnea is a fairly common complaint during pregnancy. However, if one excludes allergic nasal congestion of pregnancy, upper airway obstruction is a distinctly uncommon cause of dyspnea in the pregnant patient. Three cases of laryngeal rhinoscleroma in pregnant women requiring tracheostomy for airway management are reported. All three delivered healthy infants vaginally. Postpartum, two of the three were successfully decannulated, while the third became pregnant again before decannulation was accomplished. Treatment options and a review of the literature are presented.

Literature statistics do not support a growth stimulating role for female sex steroid hormones in haemangiomas and meningiomas

A literature review of pregnancy-related vertebral haemangiomas, pregnancy-related haemangiomas outside the nervous system and its coverings, and pregnancy-related meningiomas was performed. All three conditions tended to occur during the first pregnancy, the second or third trimester, to ameliorate postpartum, and to recur during a subsequent pregnancy. These results suggested a hormonal influence on the clinical expression of haemangiomas and meningiomas. To test whether a hormonal factor is also operative in the (not pregnancy related) symptomatic and asymptomatic counterparts of these conditions we also reviewed the literature concerning the symptomatic and asymptomatic haemangiomas and meningiomas for the following: frequency, sex and age distribution. No arguments were found to suggest that steroid hormones are strong factors in the development of asymptomatic and symptomatic lesions. The pregnancy-related counterparts have to be considered as subsets with their own behaviour.

Venous haemangioma of the neck and mediastinum

A case of cervico-mediastinal venous haemangioma with diffuse upper respiratory airway involvement is reported. The lesion was considered to be an ordinary supraglottic haemangioma at first. We recommend that adult cases of laryngeal haemangioma should be carefully examined for extra-laryngeal lesions.