BenignLesionoftheLarynx..pptVIP

Lymphatic and venous malformation Large hemangioma vascular malformation: Interstitial Nd:YAG laser therapy (power density, 1,300 – 3,300 W/cm2). Partly complemented by a noncontact mode Nd:YAG laser light application (energy density, 1,000 – 2,500 J/cm2). 60% complete clinical regression. 35.8% partial regression. Lymphatic and venous malformation Subglottic hemangiomas (children): sessile lesions, cutaneous hemangiomas. red or dark blue, compressible, unilateral. airway distress or stridor. spontaneous involution (usually at age 1). systemic steroids and tracheotomy. endoscopic resection with the CO2 laser. Nd:YAG laser is not recommended. Lymphatic and venous malformation Capillary type hemangiomas: involute spontaneously (7 y/o). treatment may not be necessary. Lymphatic and venous malformation Cidofovir: 25 mg/kg once a week. Complete suppression of hemangioma development. Antitumor or antiangiogenic effect. Granular cell tumor Schwann cells. Skin and mucous membranes of the head and neck area. Two types: mucosal granular cell tumor. congenital epulis or gingival giant cell tumor. Granular cell tumor Tongue. Larynx (3%). Posterior two thirds of the true cord or arytenoid. Solitary, polypoid, sessile, papillary, or cystic. 1 cm or smaller. Hoarseness. Granular cell tumor Histology: Keratin pearls. Pseudo-epitheliomatous hyperplasia. Squamous cell carcinoma. Granular cell tumor Complete excision. Small tumors: endoscopic removal (laser). Large tumors: laryngofissure or conservative resection. Recurrence rate (large tumor) 8%. Chondroma 40 - 60 y/o. men : women = 4 :1. Epiglottis, cricoid, arytenoid, or thyroid cartilages. Hoarseness, dyspnea, and dysphagia. Insidious due to slow growth rate. Sensation of pressure or fullness, frequent throat clearing. Chondroma Hyaline cartilage. Smooth, firm, round submucosal or nodular mass Plain soft-tissue radiographs, laryngeal tomograms, CT scans. Small biopsy (hard). CO2 laser: wedge biopsy. Chondro