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[Treatment for infantile subglottic hemangioma with oral propranolol]

Wei Chen1, Jiarui Chen1, Shumei Chen1

  • 1Department of Otolaryngology Head and Neck Surgery，Shanghai Children's Hospital，Shanghai Jiao Tong University，Shanghai，200062，China.

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Journal of Clinical Otorhinolaryngology Head and Neck Surgery
|January 3, 2022
PubMed

Insights

Infantile subglottic hemangioma (SGH) requires prompt diagnosis, especially in infants under two with stridor. Oral propranolol is a safe and effective treatment for SGH, with therapy termination around 19 months potentially reducing recurrence.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Pulmonology
  • Pediatric Pharmacology

Background:

  • Infantile subglottic hemangioma (SGH) is a rare benign tumor that can cause life-threatening airway obstruction.
  • Diagnosis can be challenging, often requiring advanced imaging and direct visualization.
  • Standard treatments may have limited efficacy or lead to recurrence.

Purpose of the Study:

  • To investigate the clinical characteristics of infantile subglottic hemangioma (SGH).
  • To evaluate the safety and efficacy of propranolol in treating SGH in infants.
  • To determine optimal treatment duration to minimize recurrence.

Main Methods:

  • Retrospective analysis of 13 children with SGH treated with propranolol.
  • Diagnostic methods included laryngoscopy and contrast-enhanced CT scans.
  • Propranolol dosage initiated at 1 mg/kg/day, escalated to 1.5 mg/kg/day, with careful monitoring.

Main Results:

  • All 13 patients achieved a cure with propranolol treatment.
  • Average age at therapy termination was 19.3 months, with treatment durations averaging 13.3 months.
  • Long-term follow-up (average 46.8 months) showed no significant adverse events.

Conclusions:

  • Subglottic hemangioma should be suspected in infants under two with persistent or recurrent stridor despite routine treatment.
  • Laryngoscopy and contrast-enhanced CT are recommended for diagnosis.
  • Oral propranolol is a safe and effective treatment for SGH, with extended treatment duration potentially reducing recurrence.

Keywords:
infantpropranololsubglottic hemangioma

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