My Sanford Chart allows you secure online access to your personal health information and your child's health information. It's available anywhere you have internet access. There is no cost to you and registering is quick and simple.

Sign Up for My Sanford Chart

Playing Again



Alex Espenson’s best friend noticed it first.

The nine-year-old Windom, Minn. boy was sitting in class when his buddy leaned over and pointed to his neck. Up until that point it had been just an ordinary day in school.

Neither Alex, nor his parents noticed anything wrong when he walked through the school doors the morning of Dec. 1. However, sometime during his teacher’s lessons that day, a vein on the side of his neck suddenly bulged out.

“It was weird,” says the quiet third-grade student who doesn’t talk much, but loves to play sports, especially hockey. “I didn’t know what to think.”

A specialist’s care

Their family doctor soon referred the family to Sanford Ear Nose and Throat specialists, said Alex’s mother Cindy. His parents were worried about what could possibly cause such a sudden change in the boy’s neck.

“He’d never had a problem before,” Cindy said. “We were perplexed about what it might be.”

Alex made an appointment with pediatric ENT specialist, Dr. Patrick Munson. The doctor, who is the only fellowship trained ENT specialist in the region who concentrates on children, quickly diagnosed his problem.

An unusual problem

The boy was suffering from a lymphatic vascular anomaly, a rare condition likely present since his birth. A venous malformation like Alex had occurs in about 1 in 10,000 people, the doctor said.

An area in his throat containing his lymph nodes had not formed properly. In most cases, the problem is either visible at birth or shows up in the first few years of life. Alex’s malformation didn’t show up until an underlying infection caused it to suddenly bulge out, says Dr. Munson.

Left untreated, the mass is unattractive, but that’s not the only problem, the specialist said. The bulge could continue to grow, blocking off the boy’s breathing or his ability to swallow. Unless the anomaly is completely removed, Alex would run the risk of continuing problems along the veins of his neck.”

“A few years ago, this would have been something that we would have been hesitant to treat,” Dr. Munson said. “It is a complex area to perform surgery due to everything that’s there in the throat.”

However, once Cindy & Jason consulted with the pediatric ENT doctor, she knew surgical treatment would be the best option for her son. Dr. Munson explained how he could remove the malformed lymphatic tissue before it swelled further and or put any further pressure on Alex’s trachea or facial nerves.

The right experience

While his family was worried about surgery to such a sensitive area, where groups of lymph nodes are intertwine with major veins and arteries, along the throat, Dr. Munson was experienced in fixing the problem, Cindy said.

The family made an appointment for the procedure. During the nearly four-hour surgery, the ENT specialist made an incision in Alex’s neck, removing a mass that was quite large -- nine centimeters by six centimeters. Throughout the surgery, the family was given regular updates on their son’s condition.

“They not only took care of our child, but they took care of the whole family as well,” Cindy said. “I was convinced he would be fine.”

Looking at “before” pictures in Dr. Munson’s office, it’s hard to believe that the images depict the same child, Cindy says. Today, Alex shows no signs of the large bulge in his throat. And his family knows that the changes of the problem reoccurring are slim.

“It’s nice to know that we don’t have to worry about it coming back,” says Alex’s mom, putting her hand on his shoulder.

Her son says the worst part of the whole experience was having to miss hockey practice for a few weeks while his throat healed. He watches the doctor trace the spot on the photographs marking the bulging mass, displaying a shy smile.

“I’m glad it’s gone,” he says, simply. “I can play again.”

Posted Date: April 2012

Playing Again

A sudden bulge in Alex Espenson’s neck left his parents perplexed and worried. How would a pediatric Ear, Nose and Throat specialist fix this nine-year-old patient’s problem?