International Journal of Otorhinolaryngology

Research Article | | Peer-Reviewed |

Endovascular Management of Massive Bleeding from Laryngeal Tumor

Received: 14 May 2023    Accepted: 8 July 2023    Published: 31 July 2023
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Abstract

Laryngeal tumors are commonly seen in Ear, Nose and Throat (ENT) department. Hemoptysis is one of the common presentations of these tumors. Carotid blowout syndrome (CBS) due to bleeding from the pseudo-aneurysm (PA) is a dreaded complication of head and neck tumors. Sometimes it can be massive and difficult to control and maybe fatal. Surgical bypass or ligation of external carotid was the only option available, but it had high mortality and morbidity associated with it. Endovascular management has given a new hope for these patients, in the form of covered stent implantation. These endovascular stents works by reconstructing the arterial wall, maintain its patency and decrease the ischemic complication rate which was higher with surgical option due to vessel deconstruction strategies. Recurrent bleeding can occur due to infection of stent which is a fearful complication but it occurs late and its reported rate in the previous studies ranges from 33-86%. We present a case of such tumor complicated with massive bleeding, which was managed by an endovascular approach. This is probably the first case where massive bleeding from the laryngeal tumor was managed with endovascular stent and embolization of blood vessels supplying the larynx.

DOI 10.11648/j.ijo.20230902.13
Published in International Journal of Otorhinolaryngology (Volume 9, Issue 2, December 2023)
Page(s) 26-29
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Laryngeal Tumor, Bleeding, Embolization

References
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[2] Barnes L, Eveson JW, Reichart P, Sidransky D. World Health Organization Classification of Tumours: Pathology and Genetics of Head and Neck Tumours. Lyon: IARC Press; 2005.
[3] Canova C, Richiardi L, Merletti F, Pentenero M, Gervasio C, Tanturri G, et al. Alcohol, tobacco and genetic susceptibility In relation to cancers of the upper aerodigestive tract in northern Italy. Tumori. 2010; 96: 1–10.
[4] Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF. An an update on larynx cancer. CA: A Cancer Journal for Clinicians. 2017; 67 (1): 31-50.
[5] Remmelts AJ, Hoebers FJP, Klop WMC, Balm AJM, Hamming-Vrieze O, van den Brekel MWM. Evaluation of laser surgery and radiotherapy as treatment modalities in early stage laryngeal carcinoma: tumour outcome and quality of voice. Eur Arch Otorhinolaryngol. 2013; 270 (7): 2079-2087.
[6] Pereira J, Phan T. Management of bleeding in patients with advanced cancer. Oncologist. 2004; 9 (5): 561-570.
[7] Johnstone C, Rich SE. Bleeding in cancer patients and its treatment: a review. Ann Palliat Med. 2018; 7 (2): 265-273.
[8] Soria JC, Deutsch E. Hemorrhage caused by antiangiogenic therapy within previously irradiated areas: expected consequence of tumor shrinkage or a warning for antiangiogenic agents combined to radiotherapy? Ann Oncol. 2011; 22 (6): 1247-1249.
[9] Weycker D, Hatfield M, Grossman A, et al. Risk and consequences of chemotherapy-induced thrombocytopenia in US clinical practice. BMC Cancer. 2019; 19 (1): 151.
[10] Rosenthal DI, Mohamed AS, Weber RS, et al. Long-term outcomes after surgical or nonsurgical initial therapy for patients with T4 squamous cell carcinoma of the larynx: a 3-decade survey. Cancer. 2015; 121 (10): 1608- 1619.
[11] Sadoughi B. Quality of life after conservation surgery for laryngeal cancer. Otolaryngol Clin North Am. 2015; 48 (4): 655- 665.
[12] Shuman AG, Larkin K, Thomas D, et al. Patient reflections on decision making for laryngeal cancer treatment. Otolaryngol Head Neck Surg. 2017; 156 (2): 299- 304.
[13] Lotempio MM, Wang KH, Sadeghi A, Delacure MD, Juillard GF, Wang MB. Comparison of quality of life outcomes in laryngeal cancer patients following chemoradiation vs. total laryngectomy. Otolaryngol Head Neck Surg. 2005; 132 (6): 948- 953.
[14] Hamilton DW, Bins JE, McMeekin P, et al. Quality compared to quantity of life in laryngeal cancer: a time trade-off study. Head Neck. 2016; 38 (S1): E631- E637.
[15] Citardi MJ, Chaloupka JC, Son YH et al. Management of carotid artery rupture by monitored endovascular therapeutic occlusion (1988–1994). Laryngoscope 1995; 105: 1086–92.
[16] Lesley WS, Chaloupka JC, Weigele JB, et al.. Preliminary experience with endovascular reconstruction for the management of carotid blowout syndrome. AJNR Am J Neuroradiol 2003; 24: 975–81.
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  • APA Style

    Bharadwaj, R., Datta, G., Pruthi, T., Mittal, S. (2023). Endovascular Management of Massive Bleeding from Laryngeal Tumor. International Journal of Otorhinolaryngology, 9(2), 26-29. https://doi.org/10.11648/j.ijo.20230902.13

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    ACS Style

    Bharadwaj, R.; Datta, G.; Pruthi, T.; Mittal, S. Endovascular Management of Massive Bleeding from Laryngeal Tumor. Int. J. Otorhinolaryngol. 2023, 9(2), 26-29. doi: 10.11648/j.ijo.20230902.13

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    AMA Style

    Bharadwaj R, Datta G, Pruthi T, Mittal S. Endovascular Management of Massive Bleeding from Laryngeal Tumor. Int J Otorhinolaryngol. 2023;9(2):26-29. doi: 10.11648/j.ijo.20230902.13

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  • @article{10.11648/j.ijo.20230902.13,
      author = {Rajeev Bharadwaj and Ginni Datta and Taniya Pruthi and Saurav Mittal},
      title = {Endovascular Management of Massive Bleeding from Laryngeal Tumor},
      journal = {International Journal of Otorhinolaryngology},
      volume = {9},
      number = {2},
      pages = {26-29},
      doi = {10.11648/j.ijo.20230902.13},
      url = {https://doi.org/10.11648/j.ijo.20230902.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijo.20230902.13},
      abstract = {Laryngeal tumors are commonly seen in Ear, Nose and Throat (ENT) department. Hemoptysis is one of the common presentations of these tumors. Carotid blowout syndrome (CBS) due to bleeding from the pseudo-aneurysm (PA) is a dreaded complication of head and neck tumors. Sometimes it can be massive and difficult to control and maybe fatal. Surgical bypass or ligation of external carotid was the only option available, but it had high mortality and morbidity associated with it. Endovascular management has given a new hope for these patients, in the form of covered stent implantation. These endovascular stents works by reconstructing the arterial wall, maintain its patency and decrease the ischemic complication rate which was higher with surgical option due to vessel deconstruction strategies. Recurrent bleeding can occur due to infection of stent which is a fearful complication but it occurs late and its reported rate in the previous studies ranges from 33-86%. We present a case of such tumor complicated with massive bleeding, which was managed by an endovascular approach. This is probably the first case where massive bleeding from the laryngeal tumor was managed with endovascular stent and embolization of blood vessels supplying the larynx.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Endovascular Management of Massive Bleeding from Laryngeal Tumor
    AU  - Rajeev Bharadwaj
    AU  - Ginni Datta
    AU  - Taniya Pruthi
    AU  - Saurav Mittal
    Y1  - 2023/07/31
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ijo.20230902.13
    DO  - 10.11648/j.ijo.20230902.13
    T2  - International Journal of Otorhinolaryngology
    JF  - International Journal of Otorhinolaryngology
    JO  - International Journal of Otorhinolaryngology
    SP  - 26
    EP  - 29
    PB  - Science Publishing Group
    SN  - 2472-2413
    UR  - https://doi.org/10.11648/j.ijo.20230902.13
    AB  - Laryngeal tumors are commonly seen in Ear, Nose and Throat (ENT) department. Hemoptysis is one of the common presentations of these tumors. Carotid blowout syndrome (CBS) due to bleeding from the pseudo-aneurysm (PA) is a dreaded complication of head and neck tumors. Sometimes it can be massive and difficult to control and maybe fatal. Surgical bypass or ligation of external carotid was the only option available, but it had high mortality and morbidity associated with it. Endovascular management has given a new hope for these patients, in the form of covered stent implantation. These endovascular stents works by reconstructing the arterial wall, maintain its patency and decrease the ischemic complication rate which was higher with surgical option due to vessel deconstruction strategies. Recurrent bleeding can occur due to infection of stent which is a fearful complication but it occurs late and its reported rate in the previous studies ranges from 33-86%. We present a case of such tumor complicated with massive bleeding, which was managed by an endovascular approach. This is probably the first case where massive bleeding from the laryngeal tumor was managed with endovascular stent and embolization of blood vessels supplying the larynx.
    VL  - 9
    IS  - 2
    ER  - 

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Author Information
  • Department of Cardiology, MM Institute of Medical Sciences and Research, Ambala, India

  • Department of Otorhinolaryngology, MM Institute of Medical Sciences and Research, Ambala, India

  • Department of Cardiology, MM Institute of Medical Sciences and Research, Ambala, India

  • Department of Cardiology, MM Institute of Medical Sciences and Research, Ambala, India

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