The biology and management of laryngeal neurofibroma

Reza Rahbar*, Biana G. Litrovnik, Sara O. Vargas, Caroline D. Robson, Roger C. Nuss, Mira B. Irons, Trevor J. McGill, Gerald B. Healy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Objectives: To review the presentation of laryngeal neurofibroma, including its association with neurofibromatosis types 1 and 2, and present guidelines for its management. Design: Retrospective study. Patients: Five pediatric patients with laryngeal neurofibroma, 4 girls (80%) and 1 boy (20%), were treated at a tertiary pediatric medical center from 1973 through 2003. Recorded data included age at initial presentation, sex, symptoms, significant medical and family history, preoperative evaluation, location of the tumor, surgical procedure, complications, outcome, and recurrence. Results: The 5 patients presented with stridor and caféau-lait spots at or shortly after birth. All patients were diagnosed as having neurofibromatosis type 1 by the established criteria. Studies evaluating the disease processes included plain radiography, computerized tomography, magnetic resonance imaging, barium swallow, and laryngoscopy and bronchoscopy under anesthesia. Pathologic examination of biopsy specimens from all patients showed neurofibromas with plexiform and/or diffuse features. Treatments included tracheotomy (n=4), carbon dioxide laser excision (n=4), modified neck dissection (n=3), partial pharyngectomy (n=1), supraglottic laryngectomy (n=1), and endoscopic hemilaryngectomy (n=1). Three patients were successfully decannulated. Follow-up ranged from 1 to 15 years. One patient was lost to follow-up. No evidence of malignant degeneration was noted. Conclusions: Neurofibroma of the larynx is a rare condition that should be considered in the differential diagnosis of children with a submucosal laryngeal mass. In our series, all patients had associated neurofibromatosis type 1. Complete surgical excision is the treatment of choice in cases of localized small lesions. To prevent debilitating outcomes due to aggressive surgery, minimally invasive procedures (partial excision via endoscopic approach) may be preferable for larger lesions that infiltrate the surrounding vital structures. Long-term follow up of these patients is essential owing to the possibility of malignant transformation.

Original languageEnglish (US)
Pages (from-to)1400-1406
Number of pages7
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume130
Issue number12
DOIs
StatePublished - Dec 2004
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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