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Management of hemangiomas of the head and neck in children
J A Bartlett1, K H Riding, L J Salkeld
1Department of Surgery, University of British Columbia, Vancouver, Canada.
Insights
Pediatric hemangiomas, common in the head and neck, can cause serious complications. While most resolve naturally, various treatments are available for complicated cases.
Area of Science:
- Pediatric dermatology and oncology
- Vascular anomalies research
- Head and neck surgery
Background:
- Hemangiomas affect about 1% of Caucasian children, frequently presenting in the head and neck region.
- These benign vascular tumors can lead to significant morbidity and mortality due to complications.
Observation:
- Complications include ulceration, infection, hemorrhage, airway obstruction, and cosmetic disfigurement.
- The natural history typically involves spontaneous regression.
- Treatment is reserved for hemangiomas with impending or actual complications.
Findings:
- A range of treatment modalities exist, including embolization, surgery, laser, cryotherapy, and medical therapies (steroids, antifibrinolytics).
- Radiotherapy is rarely used due to risks of secondary malignancies.
- The study reviews lesion natural history, treatment options, and their indications.
Implications:
- Understanding hemangioma behavior guides timely and appropriate therapeutic interventions.
- Effective management strategies can mitigate severe complications and improve patient outcomes.
- This review aids clinicians in selecting optimal treatments for pediatric head and neck hemangiomas.
Abstract:
Hemangiomas occur in approximately 1% of Caucasian children, and the head and neck is a common site of presentation. Lesions in this region may cause morbidity and occasionally mortality by virtue of complications such as ulceration, infection, hemorrhage, hemodynamic change, aerodigestive tract obstruction and disfigurement. The majority of hemangiomas regress spontaneously. Those with impending complications may require treatment with several modalities. Embolization, surgery, laser therapy, cryotherapy and medical therapy with steroids and antifibrinolytic agents may be used in selected situations. Radiotherapy is now rarely favored due to potential induction of late malignancies. The natural history of these lesions is discussed along with the treatment modalities available and indications for use. Several representative cases are presented.