Management of congenital subglottic hemangioma: Trends and success over the past 17 years

Bitar, Mohamed A.; Moukarbel, Roger V; Zalzal, George H.

doi:10.1016/j.otohns.2004.09.136

Cited by 100 publications

(86 citation statements)

References 26 publications

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“…A total of 80% to 90% of affected infants will present within the first 6 months of life, with a mean age of 3.6 months at diagnosis. 316,317 Most develop biphasic stridor and barky cough as the IH enlarges in the subglottis, the narrowest portion of the pediatric airway (Fig 15). Voice and swallowing are generally normal.…”

Section: Airwaymentioning

confidence: 99%

“…317,[326][327][328][329][330] However, many clinicians have now reported success and low complication rates using propranolol in the management of airway IHs. 326,[331][332][333][334][335][336] Although the optimal dose and appropriate duration of therapy remain uncertain, most clinicians are dosing the drug as they would for cutaneous IH.…”

Section: Highlights Of This Sectionmentioning

confidence: 99%

“…Successful management has been achieved in 77% to 87% of cases with the use of intralesional steroids. 317,327 Airway IHs causing focal obstruction may be addressed surgically by a subtotal endoscopic approach by using a microscope or telescope or by total excision through an open approach. Subtotal approaches generally use a laser 317 or rotarypowered instrument.…”

Section: Highlights Of This Sectionmentioning

confidence: 99%

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Diagnosis and Management of Infantile Hemangioma

Darrow¹,

Mancini²,

Nopper³

et al. 2015

Pediatrics

205

290

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Infantile hemangiomas (IHs) are the most common tumors of childhood. Unlike other tumors, they have the unique ability to involute after proliferation, often leading primary care providers to assume they will resolve without intervention or consequence. Unfortunately, a subset of IHs rapidly develop complications, resulting in pain, functional impairment, or permanent disfigurement. As a result, the primary clinician has the task of determining which lesions require early consultation with a specialist. Although several recent reviews have been published, this clinical report is the first based on input from individuals representing the many specialties involved in the treatment of IH. Its purpose is to update the pediatric community regarding recent discoveries in IH pathogenesis, treatment, and clinical associations and to provide a basis for clinical decision-making in the management of IH.

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Section: Airwaymentioning

confidence: 99%

Section: Highlights Of This Sectionmentioning

confidence: 99%

Section: Highlights Of This Sectionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and Management of Infantile Hemangioma

Darrow¹,

Mancini²,

Nopper³

et al. 2015

Pediatrics

205

290

View full text Add to dashboard Cite

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“…Besides, a review of the recently published series found that a mean of two procedures and a range of 1-5 procedures were required. 9 Additionally, the postoperative complication of significant subglottic stenosis is not uncommon (20%-25%). 4,10 Argon laser (488-514 nm) has been reported to be used for ISH for the ability being absorbed by hemoglobulin; 11 however, for its small spot size (0.1-1 mm) and poor penetration depth (1.5 mm), 12 the coagulative ability may be not sufficient to prevent potential postoperative bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…6 High success rate (91%) and low complications (1 subglottic stenosis of 23 patients; 4.3%) of Nd:YAG laser have also been reviewed in previous literature. 9 In addition, Nd:YAG laser can be delivered via a flexible fiber to contact directly with the lesion in a complex airway. By contrast, CO 2 laser needs to aim the target on beeline with difficulty in approaching lesions in distal and winding airway.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Nd:YAG laser therapy of infantile subglottic hemangioma

Lee

Fang

et al. 2006

Pediatric Pulmonology

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Summary. Of the many therapeutic modalities that have been developed for infantile subglottic hemangioma (ISH), the most common technique is endoscopic excision with carbon dioxide laser, used alone or combined with other therapeutic techniques. A staged procedure has been proposed as the preferred choice for patients with severe airway obstruction. Nevertheless, ever since the neodymium: yttrium-aluminum-garnet (Nd:YAG) laser was developed, this modality has been considered feasible to treat vascular tumor in the airway due to good hemostasis power. We present two cases of ISH with severe airway obstruction that underwent endoscopic surgery using an one-stage Nd:YAG laser approach. Details of the laser characteristics and surgery techniques are described in this article.

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How Airway Venous Malformations Differ From Airway Infantile Hemangiomas

Parhizkar¹,

Manning²,

Inglis³

et al. 2011

Arch Otolaryngol Head Neck Surg

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Objective To compare airway infantile hemangiomas (IHs) and venous malformations (VMs) clinically, radiographically, endoscopically, and histologically. Design Retrospective cohort study. Setting Tertiary care pediatric hospital. Patients The study included patients seen in the Vascular Anomaly Clinic, Seattle Children’s Hospital, Seattle, Washington, between 2001 and 2008. Methods All patients with airway vascular anomalies were identified by searching the Vascular Anomaly Quality Improvement Database and hospital discharge data. The data, which were analyzed with descriptive statistics and the Fisher exact test, included presenting age, sex, presenting signs, lesion site, and radiographic, endoscopic, and histologic findings.. Results Seventeen patients with airway lesions were identified, 6 with VMs and 11 with IHs. Patients with VMs presented at a mean (SD) age of 11.3 (13.7) months (age range, 3–39 months), while those with IHs presented at 3 (1.8) months of age (age range, 1–6 months) (P =.03). The patients with IHs were predominantly female (9 of 11 [81%]), while no sex difference was noted among the patients with VMs (3 of 6 [50%]). All patients with IHs presented with stridor and cutaneous lesions, whereas patients with VMs more often presented with hemoptysis or dysphagia (P = .001). Computed tomographic angiograms demonstrated enhancing endolaryngeal lesions in all IHs, while VMs enhanced poorly. Endoscopically, IHs were transglottic, while VMs were postcricoid or epiglottic (P <.001). Histologically, immunostained lesions showed submucosal lobules of capillaries lined by GLUT-1 (glucose transporter isoform 1)–positive endothelium in IHs, whereas VMs consisted of loosely organized venous channels that lacked GLUT-1 staining. Conclusion Patients with airway IHs and VMs differ in presenting age and signs, sex, airway lesion location, enhancement on computed tomographic angiograms, and histologic appearance.

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Management of congenital subglottic hemangioma: Trends and success over the past 17 years

Abstract: Treatment should be individualized. Guidelines are suggested. Priority is given to secure the airways. The CO 2 laser is useful when used cautiously. Steroids may be beneficial. Excision is for stubborn cases.

Cited by 100 publications

References 26 publications

Diagnosis and Management of Infantile Hemangioma

Diagnosis and Management of Infantile Hemangioma

Endoscopic Nd:YAG laser therapy of infantile subglottic hemangioma

How Airway Venous Malformations Differ From Airway Infantile Hemangiomas

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