Treatment failure with propranolol for subglottic haemangioma

Liu, Zhaobo; Yeo, Yen Huan; Jackson, Conor; Trimble, Keith

doi:10.1136/bcr-2018-227135

Cited by 4 publications

(5 citation statements)

References 9 publications

(15 reference statements)

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“…However, different authors reported variable percentages of failure-cases, ranging from 9 to 22% ( 12 , 14 , 16 ). In our opinion these percentages are over-represented, might be due to delay of diagnosis and therapy start, duration of treatment, and age at discontinuation ( 17 , 18 ).…”

Section: Discussionmentioning

confidence: 78%

Management of Upper Airway Infantile Hemangiomas: Experience of One Italian Multidisciplinary Center

et al. 2021

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Airway infantile hemangiomas (IHs) can represent a life-threatening condition since the first months of life. They may be isolated or associated to cutaneous IHs, and/or part of PHACES syndrome. Diagnosis, staging, and indication to treatment are not standardized yet despite the presence in the literature of previous case series and reviews. The diagnosis might be misleading, especially in the absence of cutaneous lesions. Airway endoscopy is the gold standard both for diagnosis and follow-up since it allows evaluation of precise localization and entity of obstruction and/or stricture. Proliferation of IH in the infant airways manifests frequently with stridor and treatment is required as soon as possible to prevent further complications. The first line of therapy is oral propranolol, but duration of treatment is not yet well-defined. All considered, we report the experience of our multidisciplinary center from 2009 to date, on 36 patients affected by airway IHs, and successfully treated with oral propranolol. Thus, the authors propose their experience for the management of airway IHs, specifically early diagnosis, when to perform endoscopy, how to interpret its findings, and when to stop the treatment.

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Section: Discussionmentioning

confidence: 78%

Management of Upper Airway Infantile Hemangiomas: Experience of One Italian Multidisciplinary Center

et al. 2021

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“…In a 2020 study by Lei Guo, 21 patients all had propranolol-resistant hemangioma (2). Zhaobo Liu (11) and J GOSWAMY (12) also reported the failure of oral propranolol in the treatment of subacoustic hemangioma.…”

Section: Discussionmentioning

confidence: 99%

Transarterial arterial sclerosing embolization for the treatment of propranolol-resistant subglottic hemangioma: Feasibility and effificacy

Liu

Song²,

Wang³

et al. 2023

Front. Oncol.

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PurposeTo assess the effectiveness and safety of transcatheter arterial sclerosing embolization (TASE) for the treatment of subglottic hemangiomas that did not respond appreciably to propranolol.Materials and MethodsThis study was a retrospective analysis. Of the 101 patients with subglottic hemangiomas admitted to our center, 10 (4 male and 6 female) patients were included in this study. All these patients underwent arterial embolization using Pingyangmycin and polyvinyl alcohol particles (300–500 μm). All patients were examined 1 month after the last treatment and monthly thereafter.ResultsTASE treatment was technically successful in all patients. Ten lesions were located in the subglottic region. The blood supply included the superior thyroid artery, brachiocephalic trunk, facial artery, and ascending pharyngeal arteries. The median maximal diameter of the hemangiomas significantly decreased from 8.5 mm before treatment to 2 mm after TASE (P <.05). The degree of laryngeal obstruction improved in all patients. No serious complications were noted. One patient developed fever postoperatively, and three patients had a mild cough.ConclusionsFor even subglottic hemangiomas with suboptimal efficacy of propranolol, TASE significantly reduced the size of hemangiomas with minimal adverse effects. It had a positive effect on the improvement of airway stenosis caused by subglottic hemangioma with poor effect of oral propranolol.

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Section: Discussionmentioning

confidence: 99%

“…Subglottic haemangiomas account for 1.5% of congenital laryngeal abnormalities [ 8 ]. They present in a paediatric population with biphasic stridor (usually a few months after birth) or as suspected recurrent episodes of croup [ 8 ]. Children with cutaneous haemangiomas have a 0.5% risk of having a concurrent subglottic haemangioma and these usually occur in the segmental subtype [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Concurrent subglottic and carotid sheath haemangiomas in a paediatric patient – an extremely rare clinical entity

Dolan

Alatsatianos

McAllister

et al. 2022

Journal of Surgical Case Reports

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Multiple haemangiomas of the head and neck area have been reported sporadically in the literature. Concurrent subglottic and carotid sheath haemangiomas have not been reported before in the paediatric population. The authors present the case of a 13-week-old child admitted under the paediatric ENT team with stridor. Diagnostic micro-laryngoscopy identified a subglottic haemangioma as the cause of stridor and subsequent magnetic resonance imaging demonstrated an incidental 7 cm carotid sheath lesion extending from the skull base to the superior mediastinum. Subsequent biopsy confirmed a benign infantile haemangioma. To our knowledge, this is the first reported case of concurrent subglottic and carotid sheath infantile haemangiomas in a paediatric patient. Here we discuss the clinical features and management of infantile haemangioma.

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Treatment failure with propranolol for subglottic haemangioma

Cited by 4 publications

References 9 publications

Management of Upper Airway Infantile Hemangiomas: Experience of One Italian Multidisciplinary Center

Management of Upper Airway Infantile Hemangiomas: Experience of One Italian Multidisciplinary Center

Transarterial arterial sclerosing embolization for the treatment of propranolol-resistant subglottic hemangioma: Feasibility and effificacy

Concurrent subglottic and carotid sheath haemangiomas in a paediatric patient – an extremely rare clinical entity

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