title: Postcricoid vascular abnormalities: hemangiomas, venous malformations, or anatomic variant.
abstract: OBJECTIVE
  Ten children with pressure-dependent postcricoid masses (PDPCM) previously referred to in the literature as hemangiomas or vascular malformations are presented. We propose these lesions represent an anatomic variant. We review previously reported cases, and report the presentation, diagnosis, and management of the patients in our series, the largest series to date.
  
  
  METHODS
  Ten patients, aged five weeks to nine months, were diagnosed, and treated or observed. Of the patients undergoing intervention, one was treated with a gastrostomy tube, fundoplication, and Propranolol therapy; and the other with CHARGE association underwent a tracheotomy.
  
  
  RESULTS
  No PDPCMs demonstrated significant interval change in size or appearance, and eight of ten patients did well with observation.
  
  
  CONCLUSIONS
  Based on current information, the majority of PDPCMs likely represent an anatomic variant rather than a hemangioma or vascular malformation. Diagnosis is most readily made with awake flexible fiberoptic laryngoscopy. Because the incidence of synchronous airway pathology is high, direct laryngoscopy and bronchoscopy without routine biopsy is recommended for symptomatic patients. Imaging should be individualized and may be helpful for ambiguous cases. Although numerous treatment modalities have been advocated based on the presumptive diagnosis of a hemangioma, treatment of PDPCMs is not necessary in the majority of cases, as most patients may be safely observed.
authors.affiliation: Pediatric Otolaryngology Head and Neck Surgery, Geisinger Medical Center, Danville, PA 17822, USA. thorsen.haugen@gmail.com
authors.forename: Thorsen W
authors.initials: TW
authors.lastname: Haugen
authors.forename: W Edward
authors.initials: WE
authors.lastname: Wood
authors.forename: Cecilia
authors.initials: C
authors.lastname: Helwig
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology; D001165:Arteriovenous Malformations / Q000175:diagnosis* / Q000628:therapy; D001707:Biopsy, Needle; D015331:Cohort Studies; D003413:Cricoid Cartilage / Q000002:abnormalities* / Q000098:blood supply* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000628:therapy; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome