Dynamic postcricoid venous malformation causing episodic airway obstruction: a multidisciplinary report

Purpose To describe a rare case and presentation of a dynamic postcricoid hypopharyngeal venous malformation in a young child, including its diagnostic work-up, and successful multidisciplinary treatment with percutaneous ethanol sclerotherapy. Materials and Methods Under general anesthesia, the patient was intubated, and the airway was evaluated by otolaryngology using a Miller laryngoscope with Hopkins rod visualization of the postcricoid region. A controlled Valsalva maneuver was performed by anesthesia to distend the venous malformation and enhance visualization. Interventional radiology then directly punctured the lesion with a 21-gauge needle, injected contrast to confirm intralesional placement, and performed sclerotherapy with 1.5 cc of 98% ethanol. Results Sclerotherapy was technically and clinically successful. Follow-up laryngoscopy demonstrated complete resolution of the patient’s symptoms along with resolution of the venous malformation without complications. Conclusion This case highlights the importance of multidisciplinary collaboration in managing dynamic airway vascular anomalies and demonstrates the safety and efficacy of percutaneous alcohol sclerotherapy for pediatric airway venous malformations.