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Management of subglottic haemangioma

  • C. Martin Bailey (a1), Patrick Froehlich (a2) and Hans L. J. Hoeve (a3)

Abstract

Two contrasting methods of treatment for paediatric subglottic haemangioma are presented. Dr. Hoeve describes his results using intralesional steroids and short-term intubation, and Dr. Froehlich discusses his outcomes with open surgical excision. Mr. Bailey then reviews the currently available therapeutic options with special reference to each of the above techniques, and suggests an optimum plan of management given our current state of knowledge.

The conclusion is that very small haemangiomas may not require treatment, or may be amenable to CO2 laser vaporization. Medium-sized lesions seem suitable for intra-lesional steroids and intubation, but large ones are probably best managed by primary submucous resection. Very large haemangiomas, and especially those which are circumferential or in which magnetic resonance imaging (MRI) shows extension down into the trachea and/or through the tracheal wall into the surrounding tissues, may be more safely dealt with by performing a tracheostomy and awaiting spontaneous involution.

Copyright

Corresponding author

Address for correspondence: Mr C. Martin Bailey B.Sc., F.R.C.S., Consultant Otolaryngologist, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH. U.K.

References

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Ferguson, C. F., Flake, C. G. (1961) Subglottic haemangioma as a cause of respiratory obstruction in infants. Annals of Otology, Rhinology and Laryngology 70: 10951112.
Hoeve, L. J., Kuppers, G. L. E., Verwoerd, C. D. A. (1997) Management of infantile subglottic hemangioma: laser vaporization, submucous resection, intubation, or intralesional steroids. International Journal of Pediatric Otorhinolaryngology 42: 179186.
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Sharp, H. S. (1949) Haemangioma of the trachea in an infant, successful removal. Journal of Laryngology and Otology 63: 413414.
Sie, K. C. Y., McGill, T., Healy, G. B. (1994) Subglottic hemangioma: ten years' experience with the carbon dioxide laser. Annals of Otology, Rhinology and Laryngology 103: 167172.
Verwoerd-Verhoef, H. L., Adriaansen, F. C. P. M., Laeijendecker, R. J., Van Osch, G. J. V. M., Verwoerd, C. D. A. (1997) Growth dynamics of the cricoid cartilage and subglottic injury. An autoradiographic and histometric study in the rabbit. European Archives of Otorhinolaryngology 254: S101S104.
Wiatrak, B. J., Reilly, J. S., Seid, A. B., Pransky, S. M., Castillo, J. V. (1996) Open surgical excision of subglottic hemangioma in children. International Journal of Pediatric Otorhinolaryngology 34: 191206.

Keywords

Management of subglottic haemangioma

  • C. Martin Bailey (a1), Patrick Froehlich (a2) and Hans L. J. Hoeve (a3)

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