# Transoral surgery with Thunderbeat© for hemangioma of the tongue base: A novel procedure. Case report

## TL;DR

A rare case of a tongue base hemangioma in an adult man was successfully treated with a new surgical technique called Thunderbeat©, which is less invasive and cost-effective.

## Contribution

The paper introduces Thunderbeat© as a novel, cost-effective transoral surgical technique for treating rare tongue base hemangiomas in adults.

## Key findings

- Cavernous hemangioma of the tongue base is extremely rare in adult males.
- Thunderbeat© surgery successfully removed the hemangioma with no recurrence after one year.
- Thunderbeat© offers advantages like vessel sealing and minimal thermal damage compared to traditional methods.

## Abstract

Hemangiomas are the most common benign tumors of the head-neck region in children and mainly affect the face, oral mucosa, lips, and tongue. The base of tongue is an extremely rare site of involvement. The incidence is higher in women and occur more frequently in infants and childhood.

We present a rare case of cavernous hemangioma of the base of tongue in a 70-year-old male patient surgically removed by Transoral Ultrasonic Surgery (TOUSS). 1-year follow up didn't show sign of recurrence.

Hemangiomas are benign proliferations of endothelial cells common in the head and neck. The etiology is uncertain: an imbalance in angiogenesis related to substances such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (BFGF) with uncontrolled proliferation of vascular elements is proposed. It can be asymptomatic or, when affecting the tongue, lead to difficulty swallowing, pain, bleeding and dyspnea.

This case report aims to stress that hemangioma should be considered in differential diagnosis in case of richly vascularized tongue base lesion, also in adult population. It would like to highlight the role of transoral ultrasonic surgery (TOUSS), which is able to achieve the same advantages as TORS with lower costs and shorter learning curve.

•Hemangiomas are the most common benign tumors of the head-neck region in children;•Cavernous hemangioma of the base of tongue is very rare, especially in adult men;•Transoral ultrasonic surgery is minimally invasive transoral surgical technique;•Thunderbeat© combines ultrasound and radiofrequency;•Thunderbeat© ensures vessel sealing, fast cutting, minimal adjacent thermal damage.

Hemangiomas are the most common benign tumors of the head-neck region in children;

Cavernous hemangioma of the base of tongue is very rare, especially in adult men;

Transoral ultrasonic surgery is minimally invasive transoral surgical technique;

Thunderbeat© combines ultrasound and radiofrequency;

Thunderbeat© ensures vessel sealing, fast cutting, minimal adjacent thermal damage.