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Laryngeal angioma: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Laryngeal angioma is divided into hemangiomas and lymphangiomas.
True hemangiomas of the larynx are very rare in otolaryngology and, according to various authors, make up approximately 1% of all benign tumors of the larynx. According to V.A. Borodulina (1948), up to 1948, only 119 cases of laryngeal hemangiomas were published in all available world literature, and the Romanian author N. Costinescu (1964) observed only 4 cases of this disease from 1937 to 1964.
[ Pathological anatomy of laryngeal angioma
Structurally, laryngeal hemangiomas are telangiectasias, but more often cavernous angiomas. In early childhood, capillary laryngeal hemangiomas predominate, in adults - cavernous.
Lymphangiomas of the larynx are much less common than hemangiomas and are usually localized on the epiglottis, aryepiglottic folds, vocal folds, in the ventricles of the larynx and in the subglottic space. Hemangiomas of the larynx often extend into the pyriform sinuses, into the fossae of the epiglottis, tonsils and soft palate, and may be combined with hemangiomas of the face and upper neck. A telangiectatic hemangioma of the larynx looks like a red spot slightly elevated above the surface of the mucous membrane; lymphangioma is paler in color and has a yellowish-pinkish color, containing milky fluid. Telangiectasias usually bleed little when damaged, unlike cavernous hemangiomas, which are prone to spontaneous bleeding or quite profuse bleeding when damaged.
Symptoms of laryngeal angioma
Minor laryngeal angiomas are clinically asymptomatic, especially small telangiectasias, and are discovered accidentally during endoscopic examination of the larynx. This form of laryngeal hemangiomas does not increase in size for a long time, then for no apparent reason begins to increase rapidly, acquiring the structure of a cavernous hemangioma. In women, intensive growth of laryngeal hemangiomas is observed during menstruation and pregnancy. Frequently recurring hemorrhages often lead to severe anemia.
Diagnosis of laryngeal angioma
The diagnosis of "laryngeal angioma" is easily established by the typical appearance of the tumor; as for determining its prevalence, in some cases methods of vasography with contrast, MRI, and fibrolaryngoscopy are used. Biopsy is contraindicated in any form of hemangioma due to the risk of profuse bleeding with an unpredictable outcome.
Differential diagnostics of laryngeal angioma is carried out with fibroangiomatous polyps of the larynx, myxoma, and sarcoma.
What do need to examine?
Treatment of laryngeal angioma
Due to the slow development of laryngeal hemangiomas and when the tumor does not cause any subjective disorders, dynamic observation should be limited. Small laryngeal angiomas that cause phonation disorders can be removed with subsequent cauterization of the surface on which they were located. In the case of large cavernous hemangiomas, some authors recommend ligating the external carotid artery on the corresponding side to reduce the likelihood of aneurysmal development of the process, reduce the risk of bleeding, and as preoperative preparation. In some cases, provisional tracheotomy is also used as preoperative preparation, which is also performed in attempts to obliterate the hemangioma by introducing sclerosing agents (quinine, urethane, alcohol, etc.). Large laryngeal hemangiomas are removed from the external approach, for example, through a laryngofissure.
The development of laser surgery has made it possible to significantly expand the indications for the extirpation of laryngeal hemangiomas and perform it even in newborns.
For surgical interventions of this kind, a low-energy surgical carbon dioxide laser is used, which has the property of coagulating vessels and sharply minimizing bleeding. The operation is performed under endotracheal anesthesia, with artificial ventilation and muscle relaxation. If the endotracheal tube interferes with the operation, W. Steiner and J. Werner (2000) allow its extraction for a short, biologically acceptable time and performing surgical manipulations in the patient's state of apnea. As an alternative, injector (reactive) artificial ventilation can be used.