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Updated: Jul 2, 2026
Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection
Published on: April 12, 2024
Treatment of congenital subglottic hemangiomas: our experience compared with reports in the literature
Roberto Saetti1, Marina Silvestrini, Cesare Cutrone
1Division of Airway Endoscopic Surgery, Azienda Ospedaliera, Università di Padova, Via Giustiniani 2, 35100 Padova, Italy. saetti@gmail.com
Insights
Diode laser endoscopic surgery offers the highest success rate (95%) for treating congenital subglottic hemangiomas, minimizing airway obstruction and intubation needs. Corticosteroids may serve as an adjunctive therapy.
Area of Science:
- Pediatric Otolaryngology
- Laser Surgery
- Vascular Malformations
Background:
- Congenital subglottic hemangiomas are benign vascular tumors that can cause significant airway obstruction in infants.
- Treatment options have evolved, seeking minimally invasive and effective solutions.
Purpose of the Study:
- To evaluate the outcomes of different treatment modalities for congenital subglottic hemangiomas.
- To compare the efficacy and safety of systemic steroids, intralesional corticosteroids, and diode laser surgery.
Main Methods:
- Retrospective review of 39 pediatric patients treated between 1986 and 2006.
- Patients received primary treatment with systemic steroids, intralesional corticosteroids with intubation, or diode laser surgery.
- Outcomes assessed included symptom resolution, airway obstruction, intubation requirements, and complications.
Main Results:
- Diode laser surgery achieved a 95% success rate with a 9% complication rate.
- Systemic steroids alone had a 50% success rate, with 18% experiencing adverse effects.
- Intralesional corticosteroids followed by intubation had a 73% success rate.
Conclusions:
- Endoscopic diode laser surgery is the preferred treatment for congenital subglottic hemangiomas, offering the best airway security with minimal invasiveness.
- Diode laser provides a safe and effective option, reducing the need and duration of intubation.
- Corticosteroid therapy may play an adjuvant role in managing these conditions.
Objective:
To evaluate the outcome of our experience in the treatment of congenital subglottic hemangiomas.
Design:
Retrospective review of records.
Setting:
Airway tertiary care service.
Patients:
From 1986 to 2006 we treated 39 pediatric patients affected by congenital subglottic hemangiomas.
Intervention:
Therapeutic choice depended on presentation symptoms and grade of respiratory obstruction: 6 patients were primarily treated with only systemic steroids; 11 patients underwent intralesional corticosteroid injections followed by tracheal intubation and systemic steroid support; and 22 patients underwent primary diode laser treatment.
Main Outcome Measure:
The outcomes were evaluated according to 1 or more of the following criteria: resolution of symptoms, reduction of airway obstruction, the need and duration of intubation, tracheotomy decannulation, need of further treatments, and occurrence of complications.
Results:
Patients treated with only systemic steroids showed a success rate of 50% (3 of 6); patients who underwent intralesional corticosteroid injections followed by tracheal intubation and systemic steroid support reached a positive result in 73% of cases (8 of 11). On the whole, 18% of patients treated with full-dose systemic steroids developed significant adverse effects (3 of 17). The success rate was 95% among patients treated with diode laser as primary treatment (21 of 22), with a complication rate of 9% (2 of 22).
Conclusions:
Endoscopic laser surgery is the therapeutic option that most approaches the objectives of securing the airway while using the least invasive method possible and reducing to a minimum the necessity and duration of intubation. On the basis of our experience, we believe that diode laser, owing to its physical and structural features, is the safest and most effective device for the treatment of congenital subglottic hemangiomas. Treatment with intralesional or systemic corticosteroids could have an adjuvant role.