Recent updates in laryngeal hemangioma management: a scoping review

Eur Arch Otorhinolaryngol. 2024 May;281(5):2211-2222. doi: 10.1007/s00405-023-08378-y. Epub 2023 Dec 29.

Abstract

Purpose: To provide a comprehensive review of the current strategies in the management of laryngeal hemangiomas, with an aim to introduce a management algorithm that aligns with the variable clinical presentations and anatomical complexities of these lesions.

Methods: We conducted an extensive literature search across major databases using specific and general terms, combined with Boolean operators, to ensure comprehensiveness. Articles from January 2004 to August 2023 were included, with findings categorized by management approach.

Results: Laryngeal hemangiomas exhibit a spectrum of manifestations, ranging from asymptomatic lesions to those causing severe airway obstruction. Optimal management demands an individualized approach tailored to the patient's unique presentation and anatomical considerations. Diverse treatment modalities, each with distinct indications, advantages, and limitations, are explored. Notable highlights encompass the prominent role of Beta-blockers, notably Propranolol, in addressing problematic infantile hemangiomas, the nuanced efficacy of laser therapies contingent upon hemangioma type and depth, and the critical relevance of tracheotomy in emergencies. Novel approaches like transoral robotic surgery and transoral ultrasonic surgery, demonstrate promise in specific scenarios. We propose a management algorithm based on the complexity and presentation of laryngeal hemangiomas, emphasizing individualized treatment strategies, thereby addressing the unique challenges and nuances of each case.

Conclusion: Laryngeal hemangioma management requires personalized approaches informed by diverse therapies, clinical expertise, and collaboration. The review introduces an algorithm spanning observation to advanced interventions, adapting to each case's complexity. Ongoing research promises innovative treatments.

Keywords: Laryngeal hemangiomas; Laser therapies; Management; Management algorithm; Propranolol.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Hemangioma* / drug therapy
  • Hemangioma* / therapy
  • Humans
  • Laryngeal Neoplasms* / drug therapy
  • Laryngeal Neoplasms* / therapy
  • Propranolol / therapeutic use
  • Tracheostomy
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Propranolol