From the Research
Surgical excision using microlaryngeal techniques is the primary treatment option for vocal cord hemangioma, particularly in adult cases, as it allows for complete removal while preserving vocal cord function 1.
Management Approach
The management of vocal cord hemangioma involves a multidisciplinary approach tailored to the size, location, and symptoms of the lesion.
- For small, asymptomatic hemangiomas, observation with regular follow-up may be sufficient as some hemangiomas can regress spontaneously.
- When intervention is necessary, surgical excision is often the primary treatment option, allowing for complete removal while preserving vocal cord function.
- Laser surgery, particularly CO2 or KTP laser, offers precise excision with minimal bleeding and is frequently used for these vascular lesions.
Considerations for Treatment
- For larger hemangiomas, preoperative propranolol therapy may reduce the size and vascularity of the lesion, making subsequent surgery safer and more effective 2.
- In pediatric cases, propranolol has become first-line therapy, often eliminating the need for surgery 3.
- Corticosteroids may be used in some cases to reduce inflammation and size before surgical intervention.
Post-Treatment Care
- Voice therapy is an essential component of post-treatment care to restore optimal vocal function.
- Regular follow-up with laryngoscopic examination is necessary to monitor for recurrence, which can occur in some cases. This comprehensive approach aims to eliminate the hemangioma while preserving voice quality and airway patency.
Recent Evidence
Recent studies, such as the one published in 2021 2, suggest that combining propranolol with pulse dye laser may reduce propranolol duration without increasing harms, but the primary approach for vocal cord hemangioma, especially in adults, remains surgical excision 1, 4.