Coblation-assisted excision of hypopharyngeal venous malformation: a case report

Abstract

Abstract Background Adult hypopharyngeal venous malformations are rare. Unlike hemangiomas, venous malformations require surgical excision wherever feasible. We describe the case of a hypopharyngeal venous malformation and use of coblation to achieve complete excision. Case presentation A 28-year-old male presented to the emergency department with sudden-onset hematemesis, and melena for 3 days. Examination revealed a broad-based reddish polypoidal lesion (mulberry like) arising from the left aryepiglottic fold and medial wall of the pyriform sinus. Contrast-enhanced magnetic resonance scan and angiogram of the neck was done, which revealed an intensely enhancing vascular lesion. He underwent a selective embolization of the feeder vessels achieving 80% reduction in the post run blush. We excised the lesion in toto using coblation considering its superior hemostatic control and maneuverability. Conclusion The use of coblation is a relatively safe and easy technique to learn and perform in management of vascular tumor of hypopharynx and upper airway. When appropriately performed, it provides a bloodless field and causes minimal damage to surrounding tissue. However, knowledge of external approaches is mandatory for management of complications.