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Subglottic hemangiomas in infants: treatment with intralesional corticosteroid injection and intubation
Insights
Intralesional corticosteroid injections effectively treated subglottic hemangioma in children, with most patients becoming symptom-free after treatment. This method, combined with intubation, is now the preferred approach in our clinic.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Surgery
Background:
- Subglottic hemangioma is a rare, benign vascular tumor that can cause airway obstruction in infants and children.
- Traditional treatments for subglottic hemangioma have varied, with some carrying significant risks or limited efficacy.
Purpose of the Study:
- To evaluate the efficacy and safety of intralesional corticosteroid injections followed by intubation for treating subglottic hemangioma in pediatric patients.
Main Methods:
- A retrospective review of six children treated between 1982 and 1987 at Sophia Children's Hospital.
- Treatment involved intralesional corticosteroid injections, with subsequent intubation.
- Dosage and number of injections varied based on patient response.
Main Results:
- All six children achieved symptom resolution following treatment.
- Three patients required one injection, two needed three, and one required five injections.
- The average intubation duration was 19 days.
- No serious complications or need for tracheotomy were reported.
- Symptom-free status was maintained at an average follow-up of 3.3 years.
Conclusions:
- Intralesional corticosteroid injections combined with intubation represent a safe and effective treatment for subglottic hemangioma in children.
- The therapeutic effect may be enhanced by the gentle pressure exerted by the endotracheal tube.
- This treatment modality is now the standard of care for subglottic hemangioma at our institution.
Abstract:
Six children with a subglottic hemangioma were treated in the Sophia Children's Hospital in the period 1982-1987 by means of intralesional corticosteroid injection, followed by intubation. After treatment all children were symptomfree. In 3 patients this result was attained after 1 injection, in 2 after 3 injections. One patient needed 5 injections. The average duration of intubation was 19 days (7-36). Three months (1/2-7 1/2) after the onset of therapy all patients were free of symptoms. No serious complications were observed. No patient needed a tracheotomy. The average follow-up period was 3.3 years (1 1/2-5 1/2). The authors feel that not only the effect of intralesional corticosteroids, but also local gentle pressure by the tube is of therapeutic importance. The above-mentioned treatment of subglottic hemangioma in children is now the treatment of choice in our clinic.