{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T23:29:37Z","timestamp":1785713377705,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,5,13]],"date-time":"2015-05-13T00:00:00Z","timestamp":1431475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To describe a multidisciplinary approach to the treatment of airway vascular malformations (venous or lymphatic) with direct suspension rigid laryngoscopy and direct puncture transmucosal bleomycin sclerotherapy injected under road\u2010mapping fluoroscopic monitoring, supplemented by Dyna\u2010computed tomography utilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective medical record and imaging review of four patients with venous malformations or lymphatic malformations located in the airway. Patients were treated with a combination of direct suspension laryngoscopy or rigid nasopharyngoscopy and image\u2010guided direct puncture bleomycin sclerotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two patients presented to our institution with extensive lymphatic malformation of the neck, parapharyngeal, and retropharyngeal spaces, and two presented with venous malformation of the nasopharynx and oropharynx. All patients were treated with multiple sclerotherapy and debulking procedures before undergoing combined direct transmucosal puncture bleomycin sclerotherapy guided by direct laryngoscopy or nasopharyngoscopy. All patients had complete resolution of disease while maintaining a safe airway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A multidisciplinary approach to airway vascular malformations with a combination of endoscopy and direct puncture bleomycin sclerotherapy was demonstrated to be a safe and effective treatment in our patient cohort. Direct laryngoscopy and nasopharyngoscopy provide easy access to the nasopharynx, oropharynx, retro\u2010 and\/or parapharyngeal spaces and larynx. Unlike traditional agents, bleomycin induces minimal edema and therefore is an ideal substance to treat airway lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 126:205\u2013211, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25284","type":"journal-article","created":{"date-parts":[[2015,5,13]],"date-time":"2015-05-13T12:07:09Z","timestamp":1431518829000},"page":"205-211","source":"Crossref","is-referenced-by-count":20,"title":["Endoscopic transmucosal direct puncture sclerotherapy for management of airway vascular malformations"],"prefix":"10.1002","volume":"126","author":[{"given":"Karin P. Q.","family":"Oomen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Pediatric Otolaryngology\u2013Head &amp; Neck Surgery (k.p.q.o.), Weill Cornell Medical College New York New York U.S.A."},{"name":"Department of Department of Otolaryngology\u2013Head &amp; Neck Surgery Pediatric Otolaryngology\u2013Head &amp; Neck Surgery (k.p.q.o.), University Medical Center Utrecht\/Wilhelmina Children's Hospital Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Paramasivam","sequence":"additional","affiliation":[{"name":"Hyman Newmann Institute for Neurology and Neurosurgery\u2013Center for Endovascular Surgery (s.p., j.t.f., a.b.), St. Luke's Roosevelt Hospital New York NY U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton","family":"Waner","sequence":"additional","affiliation":[{"name":"Vascular Birthmark Institute of New York, Department of 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