Background: Laryngeal hemangiomas are typically found in the subglottic region in infants and children, rarely reported in supraglottic location. Clinical Description: A 3-year-old girl presented with stridor and hematemesis. She was found to have respiratory distress, chest indrawing, and hypoxia. After initial supportive care with oxygen and dexamethasone, a soft tissue neck X-ray revealed a mass in the supraglottic region. Management and Outcome: A flexible fiberoptic bronchoscopy revealed a nodular mass arising from the right arytenoid, almost occluding the airways. The mass was reduced by using laser therapy, under Soong’s ventilation strategy, followed by the initiation of propranolol therapy. The diagnosis was confirmed by histological examination. At follow-up, the child was well and symptom-free. Conclusion: Stridor associated with hematemesis in a child may be due to underlying laryngeal hemangioma, which may rarely arise from a supraglottic location. Careful laser therapy, under flexible bronchoscopic guidance, using Soong’s ventilation strategy, may help in the effective reduction of the mass.
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Indian Pediatrics Case Reports
China Medical University
Taipei Veterans General Hospital
National Defense Medical Center
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Kumar et al. (Tue,) studied this question.