Hypopharyngeal
hemangiomas are uncommon
neoplasms that can cause
dysphagia, recurrent
bleeding, and
airway obstruction. These lesions are a therapeutic challenge, and surgical resection is the mainstay of
therapy. The goal of
therapy is directed at control of the
tumor and relief of symptoms rather than total eradication of the lesion.
Laser therapy is a very useful adjunct in the management of these
vascular neoplasms. The
neodymium:
yttrium-aluminum-garnet laser (Nd:YAG laser) functions at a wavelength that provides deep thermal coagulation. This allows its use for these vascular lesions. With
laser surgery,
hemorrhage is the most frequent and dangerous complication, and its control is extremely important.
Ligation and
suture remain the traditional methods of hemostasis in most surgical situations. However, on certain occasions problems arise, particularly with large oozing surfaces or when surgical access is poor. Topical
hemostatic agents are widely used in a variety of
surgical procedures to successfully solve such problems. Microfibrillar
collagen (
Avitene) is one of the absorbable, topical,
hemostatic agents, and is used effectively to control
bleeding in many surgical situations. Since we began to use microfibrillar
collagen (AviteneTM, MedchemProduct, Inc., Woburn, MA01801) to stop the massive oozing of the
laser-induced
surgical wound, no episodes of
bleeding had ever occurred. It is concluded that
Avitene is an effective agent for maintaining hemostasis in many
surgical procedures, and we consider it a good remedy for management of
laser-induced
bleeding complications.