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Treatment of subglottic hemangiomas with propranolol: initial experience in 10 infants

Murali Mahadevan1, Alan Cheng, Colin Barber

  • 1Department of Otolaryngology, Head and Neck Surgery, Starship Children’s Hospital, Auckland, New Zealand. surgeon@entdoctor.co.nz

ANZ Journal of Surgery
|February 3, 2012
PubMed

Insights

Propranolol effectively treats infantile subglottic hemangiomas (SGH), resolving airway obstruction without surgery in all cases. While most infants showed stable regression, two experienced regrowth, necessitating further long-term study.

Area of Science:

  • Pediatric Otolaryngology
  • Neonatal Care
  • Pharmacology

Background:

  • Subglottic hemangiomas (SGH) are rare infant tumors causing significant airway obstruction.
  • Existing treatments carry potential complications.
  • Propranolol shows emerging promise for SGH management.

Purpose of the Study:

  • To evaluate the efficacy and safety of propranolol in infants with subglottic hemangiomas.
  • To assess the need for tracheostomy or surgical intervention during propranolol treatment.

Main Methods:

  • A consecutive case series of 10 infants with SGH and airway obstruction.
  • Treatment with propranolol at a dosage of 2 mg/kg/day.
  • Mean treatment duration of 7.7 months.

Main Results:

  • Complete symptom resolution in all 10 infants.
  • Eight infants achieved stable regression.
  • Two infants experienced lesion regrowth after 9 months.
  • No infant required tracheostomy or surgical removal.

Conclusions:

  • Propranolol is a promising and effective treatment for SGH with rapid onset.
  • It may reduce or eliminate the need for tracheostomy and allow corticosteroid dose tapering.
  • Long-term outcomes require further investigation with repeat laryngoscopy.
Abstract

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