The Management of Vascular Malformations of the Airway

Klosterman, Tristan; O, Teresa M.

doi:10.1016/j.otc.2017.09.013

Cited by 10 publications

(12 citation statements)

References 20 publications

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“…The mainstay of treatment is flashlamp‐pumped pulsed dye laser, which should be started as early as possible to maximize the results 60 . In extensive CM, remaining soft tissue hypertrophy sometimes requires surgical resection or CO 2 laser ablation 4,5 …”

Section: Airway Management In Vascular Anomalies Diagnosed After Birthmentioning

confidence: 99%

“…The airway must be secured if it is obstructed and protected from potential future obstruction to prevent any emergent situation. Indeed, symptoms can rapidly deteriorate with vascular anomaly growth or swelling in case of infection, trauma, intralesional bleeding and hormonal changes 5 or as a result of the treatment itself 4 . Ranging from unnoticeable to massive, perinatal and pediatric vascular anomalies with airway compromise represent a clinical challenge and requires timely management in specialized centers having multidisciplinary teams with experience in managing a difficult pediatric airway.…”

Section: Introductionmentioning

confidence: 99%

“…Both vascular tumors and vascular malformations can affect the head and neck region with potential functional and aesthetic impairments. Symptoms depend on the nature, size and the localization of the lesions and include airway compromise, obstructive sleep apnea, dysphagia, sialorrhea, impaired mastication, abnormal speech intelligibility, and facial deformities 4 . When the buccal cavity, pharynx, larynx, trachea and mediastinum are affected, management of airway compromise is the priority before definitive treatment of the vascular anomaly itself.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric vascular anomalies with airway compromise

Gorostidi

Glasson

Salati

et al. 2022

J Oral Pathology Medicine

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Vascular anomalies are rare lesions of diverse nature that may affect the head and neck region. Any mass in or around the upper airway has the potential to obstruct or compromise it. The absolute priority, before etiologic treatment, is the evaluation of the risk for the airway and its management. Prenatal diagnosis of an upper airway obstruction requires a planned delivery in a center having a specialized team experienced in managing a compromised feto-neonatal airway, and who could perform an ex-utero intrapartum treatment to secure the airway. Even after birth, the airway remains central in the patient's overall management. Signs and symptoms of airway compromise must be evaluated keeping in mind the specific requirements of infants and small children and being aware that rapid worsening may occur. The treatment is then tailored to the patient and his lesion with the goal of improving symptoms while avoiding treatment-related complications. Maintaining reasonable expectations by the patient and families are part of a successful management. Cure is achievable for small and localized lesions, but symptom relief and mitigation of functional, esthetic and psychological impairments is the goal for large and complex lesions. If a tracheotomy was required, decannulation is one of the primary management goals.

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Section: Airway Management In Vascular Anomalies Diagnosed After Birthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pediatric vascular anomalies with airway compromise

Gorostidi

Glasson

Salati

et al. 2022

J Oral Pathology Medicine

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“…Nearly three-quarters of patients with LM that involve the head and neck can compromise the airway [42] and become life-threatening, necessitating endotracheal intubation or tracheostomy. Excision, laser ablation, and sclerotherapy have been the mainstays of surgical interventions [42,43]; however, recent results from a Phase 2 pediatric and adult trial (NCT00975819) on the treatment of complex vascular anomalies [44] as well as from two smaller series [45,46], have all suggested benefit with sirolimus (rapamycin). Additionally, a French pediatric Phase 2 trial (NCT03243019) is set to begin in March 2018 to further assess the efficacy of rapamycin in the treatment of cervicofacial LM.…”

Section: Lymphatic Malformations and Airway Compromisementioning

confidence: 99%

Lymphatic dysfunction in critical illness

Burke

Datar²

2018

Current Opinion in Pediatrics

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Purpose of review The essential role of the lymphatic system in fluid homeostasis, nutrient transport, and immune trafficking is well-recognized, however there is limited understanding of the mechanisms that regulate lymphatic function, particularly in the setting of critical illness. The lymphatics likely affect disease severity and progression in every condition, from severe systemic inflammatory states to respiratory failure. Here, we review structural and functional disorders of the lymphatic system, both congenital and acquired, as they relate to care of the pediatric patient in the intensive care setting, including novel areas of research into medical and procedural therapeutic interventions. Recent findings The mainstay of current therapies for congenital and acquired lymphatic abnormalities has involved non-specific medical management or surgical procedures to obstruct or divert lymphatic flow. With the development of dynamic contrast-enhanced magnetic resonance lymphangiography, image-directed percutaneous intervention may largely replace surgery. Because of new insights into the mechanisms that regulate lymphatic biology, pharmacologic inhibitors of mTOR and leukotriene B4 signaling are each in Phase II clinical trials to treat abnormal lymphatic structure and function, respectively. Summary As our understanding of normal lymphatic biology continues to advance, we will be able to develop novel strategies to support and augment lymphatic function during critical illness and through convalescence.

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“…Secondly, these lesions have unique implications based on their anatomic location and involvement of major systems, e.g., visual, digestive, respiratory, etc. [2][3][4]. This review will focus on salient imaging findings and imaging-based prognostic considerations.…”

Section: Introductionmentioning

confidence: 99%

Vascular lesions of the head and neck: an update on classification and imaging review

2020

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Vascular lesions have a varied appearance and can commonly occur in the head and neck. A majority of these lesions are cutaneous and congenital; however, some may be acquired and malignant. The presentation and clinical history of patients presenting with head and neck lesions can be used to guide further imaging, which can provide important diagnostic and therapeutic considerations. This review discusses the revised International Society for the Study of Vascular Anomalies (ISSVA) classification system for vascular tumors and malformations, as well as explores the most common vascular anomalies including their clinical presentations and imaging findings.

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The Management of Vascular Malformations of the Airway

Cited by 10 publications

References 20 publications

Pediatric vascular anomalies with airway compromise

Pediatric vascular anomalies with airway compromise

Lymphatic dysfunction in critical illness

Vascular lesions of the head and neck: an update on classification and imaging review

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