Propranolol in the Management of Airway Infantile Hemangiomas

Abstract

Our 3 patients had severe respiratory symptoms related to their airway infantile hemangiomas. In the first patient, propranolol was used when other treatments were ineffective or associated with intolerable adverse effects. In the second and third patients, propranolol was part of a dual regimen that resulted in rapid resolution of airway symptoms and allowed for quicker weaning of corticosteroids.

Infantile Hemangioma--Mechanism(s) of Drug Action on a Vascular Tumor

“…Since then, propranolol treatment for IH has become popular worldwide and positive results with its use are reported by many groups (Cheng et al 2010;Mazereeuw-Hautier et al 2010;Rosbe et al 2010). Propranolol is a noncardioselective b-adrenergic receptor blocker used traditionally for other indications such as hypertension, angina pectoris, myocardial infarction, migraines, anxiety disorders, and tremor.…”

“…Following the administration of propranolol, a rapid change in the tumor is typically noticed, including decreased redness and softening (Sans et al 2009;Rosbe et al 2010). This raises the question of whether propranolol exerts its effect via vasoconstriction of the high-flow blood vessels feeding the IH tumor.…”

A meta-analysis on the effectiveness of propranolol for the treatment of infantile airway haemangiomas

“…A total of 24 were excluded because they did not meet the inclusion criteria. 13 studies published between 2009 and 2010 matched the selection criteria and were therefore included in the analysis [17][18][19][20][21][22][23][24][25][26][27][28][29] (Fig. 1).…”

“…Whether or not a treatment was judged to be effective was determined by the original authors using a combination of symptom resolution [17,18,[20][21][22]25,26,28], direct visualization confirming a reduction in size of the haemangioma [17,19, [ ( ) T D $ F I G ] 21,23,24] and MRI in one case which also involved the mediastinum [22].…”

Šiuolaikinis Galvos Ir Kaklo Srities Hemangiomų Gydymas

“…Siekiant užtikrinti kvėpavimo takų praeinamumą, gali tekti atlikti tracheostomiją ar greitą darinio pašalinimą lazeriu [34]. Tačiau dauguma autorių pateikia sėkmingus HA, esančių kvėpavimo takuose, gydymo propranololiu rezultatus [35]. Leboulager ir bendraautoriai pateikia sėkmingus 14 pacientų, gydytų propranololiu, duomenis: kvėpavimo takų obstrukcija po 2 savaičių gydymo buvo išlikusi tik 22 proc.…”