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Published on: August 7, 2017
Risk Factors for Airway Infantile Hemangioma
Eeva Castrén1,2,3, Päivi Salminen2,3, Kristiina Kyrklund2,3
1Department of Otorhinolaryngology and Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Infants with beard area hemangiomas face the highest risk of airway involvement. Early identification of at-risk infants with infantile hemangioma (IH) is key for timely treatment and preventing airway compromise.
Area of Science:
- Pediatric Dermatology
- Vascular Anomalies
- Neonatal Care
Background:
- Infantile hemangioma (IH) is a common vascular tumor in infants.
- Airway involvement in IH is rare but can lead to serious complications.
- Identifying infants at risk is crucial for early intervention.
Purpose of the Study:
- To determine risk factors for airway infantile hemangioma.
- To investigate the incidence of airway IH.
- To review treatment outcomes for airway IH.
Main Methods:
- Retrospective review of 798 children with IH.
- Data collected from a pediatric vascular anomaly unit (2008-2017).
- Analysis of patient demographics and IH characteristics to identify airway IH predictors.
Main Results:
- Airway IH occurred in 1.6% of the cohort.
- Segmental beard distribution hemangiomas had a 33.3% risk of airway IH.
- Focal perioral/nasal hemangiomas were present in 38.5% of infants with airway IH.
- Propranolol effectively treated 80% of airway IH cases.
Conclusions:
- Segmental beard distribution hemangiomas are the strongest indicator of airway IH risk.
- Other facial/neck segmental IHs and focal perioral/nasal IHs also pose a risk.
- Early detection and management are vital for infants with concerning IH presentations.
Aim:
An infantile hemangioma (IH) affecting the airway is rare. Identifying infants at risk for an airway IH is crucial to avoid potential airway compromise. Our objective was to identify risk factors for an airway IH and to study its incidence and treatments.
Methods:
This study included 798 children with an IH visiting our paediatric vascular anomaly unit between 1.1.2008 and 31.12.2017. Patient demographics and IH-related data were retrospectively reviewed to identify factors predisposing to an underlying airway IH.
Results:
An airway IH was diagnosed in 1.6% of the cohort. When a segmental beard distribution hemangioma was present, the risk for an airway IH was 33.3%, and when a non-beard distribution segmental hemangioma on the face or neck was observed, the risk was 11.5%. Focal hemangiomas were seen in 38.5% of infants with an airway IH, mostly in the perioral or nasal area. Propranolol was sufficient treatment for 80.0% of infants with an airway IH.
Conclusions:
The presence of a segmental beard distribution hemangioma involved the highest risk for an underlying airway IH. Children with other types of segmental IHs on the face or neck, or those with focal perioral and nasal hemangiomas were also at risk for airway involvement.
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