Emerging concepts in airway infantile hemangioma assessment and management

Otolaryngol Head Neck Surg. 2009 Aug;141(2):207-212. doi: 10.1016/j.otohns.2009.04.013.

Abstract

Objective: The purpose of this study was to evaluate changes in airway infantile hemangioma treatment.

Study design: Retrospective.

Subjects: Airway hemangioma patients, tertiary pediatric hospital.

Methods: Data collected included age at diagnosis, evaluation methods, hospitalizations, airway size, and interventions. Patients were divided into group A (1981-1993) and group B (1994-2005) and were analyzed using descriptive statistics, the Fisher exact test, and the Student t test.

Results: Thirty-two subjects were identified. Nasopharyngoscopy was used more in group B (11/16 [69%]) than group A (4/16 [25%], P=0.032). CT angiography (3/16 [19%]) and laryngeal distractors (11/16 [69%]) were only used in group B; these techniques showed airway hemangiomas to be "transglottic," not just "subglottic." Intralesional steroids alone (3/16 [19%]) and primary hemangioma excision (2/16 [13%]) were new treatments used in group B. Frequent direct laryngoscopies (>six) correlated with tracheotomy (5/32 [16%], P=0.015). Presenting age (<2 months) impacted treatment more than airway hemangioma size.

Conclusions: New methods of airway infantile hemangioma assessment changed our concept of airway hemangiomas and their primary treatment.

Publication types

  • Comparative Study

MeSH terms

  • Female
  • Glottis / surgery
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Hemangioma / diagnosis
  • Hemangioma / drug therapy*
  • Hemangioma / surgery*
  • Hospitals, University
  • Humans
  • Infant
  • Injections, Intralesional
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / drug therapy*
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods*
  • Laryngoscopy / methods*
  • Male
  • Medical Records
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome

Substances

  • Glucocorticoids