Proposal for staging airway hemangiomas

Otolaryngol Head Neck Surg. 2009 Oct;141(4):516-521. doi: 10.1016/j.otohns.2009.06.751.


Objective: To describe a method of airway infantile hemangioma staging using standardized assessment of airway narrowing, and hemangioma location and volume, as determined with endoscopy and CT angiography.

Study design: Case series with chart review.

Setting: Tertiary pediatric hospital, 2003-2008.

Subjects and methods: Subjects included airway hemangioma patients evaluated at a tertiary pediatric hospital. Data collected were age at first symptoms, diagnostic evaluation, percent airway compromise, and estimated hemangioma volume. Data were analyzed with descriptive and Fisher exact statistics.

Results: Twelve patients were identified and seven had complete data sets. Mean age at first symptoms was 1.9 months (SD 1.09 months, range 0.5-4 months). Evaluation consisted of nasopharyngoscopy, microlaryngoscopy, CT angiography, and/or MRI. Mean laryngeal airway narrowing was estimated at 63.75 percent (SD 19.0%, range 40%-90%). Total hemangioma volume was less in patients with isolated (focal) endolaryngeal hemangiomas compared with airway hemangiomas associated with extralaryngeal (segmental) hemangiomas. Airway hemangioma stages were stage one (5 of 12; 41.6%), stage two (6 of 12; 50.0%), and stage three (1 of 12; 8.3%).

Conclusion: This method of airway hemangioma staging may be applicable to treatment planning and used to measure treatment outcomes.

MeSH terms

  • Airway Obstruction / etiology
  • Angiography
  • Endoscopy
  • Female
  • Hemangioma / complications
  • Hemangioma / congenital
  • Hemangioma / diagnosis*
  • Hemangioma / pathology
  • Humans
  • Infant
  • Infant, Newborn
  • Laryngeal Neoplasms / complications
  • Laryngeal Neoplasms / congenital
  • Laryngeal Neoplasms / diagnosis*
  • Laryngeal Neoplasms / pathology
  • Laryngoscopy
  • Larynx / diagnostic imaging
  • Larynx / pathology
  • Magnetic Resonance Imaging
  • Male
  • Neoplasm Staging
  • Tomography, X-Ray Computed