Endoscopic KTP laser photocoagulation therapy for pharyngolaryngeal venous malformations in adults.
OBJECTIVE
Venous malformations are benign lesions with thin, fragile mucosa overlying a vascular stroma. Vascular anomalies often manifest as subglottic lesions in infants, but venous malformations in adults are rare in the pharyngolaryngeal region. The treatments include open and endoscopic surgery; intraoperative bleeding is often troublesome. Angiolytic lasers such as the potassium titanyl phosphate (KTP) laser enable photocoagulation for such hemorrhagic lesions without bleeding; we report findings from a series of adult patients.


METHODS
Seven adults were treated with a KTP laser set at a low power of 1.5 W in continuous mode. Photocoagulation was easily performed for shallow lesions; however, laser irradiation of bulky venous malformations resulted only in surface photocoagulation. In such cases, the crust remaining after photocoagulation was removed, and laser energy was repeatedly delivered until no remnant lesion was seen. An office procedure using flexible endoscopy was performed under topical anesthesia for 1 patient with a limited lesion.


RESULTS
The lesions were well controlled in all cases without major complications. A patient with a large obstructing lesion had a relapse. Because the recurrent lesion is small and the patient does not desire additional treatment at this time, she is being observed carefully.


CONCLUSIONS
Photocoagulation using the KTP laser is a feasible and relatively safe treatment for pharyngolaryngeal venous malformations in adults.
Kishimoto
Yo
Y
Department of Otolaryngology-Head and Neck Surgery, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan.
Hirano
Shigeru
S
Kato
Naomi
N
Suehiro
Atsushi
A
Kanemaru
Shin-ichi
S
Ito
Juichi
J
D000328:Adult; D000368:Aged; D001165:Arteriovenous Malformations / Q000601:surgery*; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000098:blood supply*; D017075:Laser Coagulation; D053844:Lasers, Solid-State; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000098:blood supply*