O-2207 THE NEED FOR TRACHEOSTOMY IN VASCULAR ANOMALIES: A LITERATURE META ANALYSIS

Vascular anomalies encompass an extremely wide spec- trum of pathologies. There are simple single angiomas which do not pose any diagnostic and therapeutic diffi- culty. On the other hand, there are extremely severe conditions such as congenital gigantic lymphatic malformations involving the upper respiratory tract that can require an Ex Utero Intrapartum Therapy (EXIT). In general, when a vascular anomaly affects the airways, there could be the risk of asphyxia spontaneously, during certain physiological conditions such as the Valsalva manoeuvre, during intubation or during the surgical man- agement of the vascular anomaly. The aim of the present paper was to extensively review the literature in the search for indications and techniques to see if a guideline can be proposed to protect the upper airways of patients affected by haemangiomas and vascu- lar malformations. In detail we tried to investigate the conditions that suggest a surgical airway versus a conservative management. As to what pertains to haemangiomas we have thoroughly reviewed the literature regarding subglottic haemangiomas treated before and after the advent of propranolol. For the vascular malformation we have considered the various clinical conditions that can suggest a surgical airway. Eventually we try to see if a guideline can be proposed.