Management of infantile subglottic hemangioma:: laser vaporization, submucous resection, intubation, or intralesional steroids?

被引:34
作者
Hoeve, LJ [1 ]
Küppers, GLE [1 ]
Verwoerd, CDA [1 ]
机构
[1] Univ Rotterdam Hosp, Sophia Childrens Hosp, Dept Otorhinolaryngol, Rotterdam, Netherlands
关键词
infantile subglottic hemangioma; laser; resection; intubation; intralesional steroids;
D O I
10.1016/S0165-5876(97)00144-4
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
The infantile subglottic hemangioma can be treated in various ways. The results of the treatment used in the Sophia Children's Hospital, intralesional steroids and intubation (IS + I), are discussed and compared with the results of other current treatment methods: CO2 laser vaporization, submucous resection and intubation alone. A total of 18 infants were treated for subglottic hemangioma in our hospital: ten with IS + I alone, five were first treated with systemic therapy and later with IS + I alone and three with various therapies. IS + I was effective in 14 of the 15 patients, one patient was lost from follow up. The remaining three infants were treated with (combinations of) various therapies, because IS + I failed Or was not tried. Two patients were finally cured, one still has a tracheotomy. Of other current therapies, CO2 laser vaporization is reported to be effective. In all 30% of the infants treated in Boston Children's Hospital with CO2 laser needed a tracheotomy. Moreover subglottic stenosis is a serious complication. Submucous resection is often successful. It may be complicated by subglottic stenosis and in some cases, depending on the localization of the hemangioma, it may be contraindicated. Intubation alone is less effective than intubation combined with intralesional steroids. Management of subglottic hemangioma in Sophia Children's Hospital is primarily intralesional steroids and intubation and secondarily submucous resection or tracheotomy. CO2 laser vaporization is seldom applied because of the risk of subglottic stenosis. (C) 1997 Published by Elsevier Science Ireland Ltd.
引用
收藏
页码:179 / 186
页数:8
相关论文
共 25 条
[1]   CONGENITAL LARYNGEAL HEMANGIOMA [J].
BENJAMIN, B ;
CARTER, P .
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 1983, 92 (05) :448-455
[2]  
BRODSKY L, 1983, ANN OTO RHINOL LARYN, V92, P4
[3]   SUBGLOTTIC HEMANGIOMA IN CHILDREN [J].
CHOA, DI ;
SMITH, MCF ;
EVANS, JNG ;
BAILEY, CM .
JOURNAL OF LARYNGOLOGY AND OTOLOGY, 1986, 100 (04) :447-454
[4]   STEROID TREATMENT OF HEMANGIOMA OF HEAD AND NECK IN CHILDREN [J].
COHEN, SR ;
WANG, CI .
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 1972, 81 (04) :584-&
[5]   LARYNGEAL STENOSIS FOLLOWING CARBON-DIOXIDE LASER IN SUBGLOTTIC HEMANGIOMA - REPORT OF 3 CASES [J].
COTTON, RT ;
TEWFIK, TL .
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 1985, 94 (05) :494-497
[6]   SUBGLOTTIC HEMANGIOMA IN INFANTS [J].
FEUERSTEIN, SS .
LARYNGOSCOPE, 1973, 83 (04) :466-475
[7]   MANAGEMENT OF SUBGLOTTIC HEMANGIOMA [J].
FROEHLICH, P ;
STAMM, D ;
FLORET, D ;
MORGON, A .
CLINICAL OTOLARYNGOLOGY, 1995, 20 (04) :336-339
[8]   TRACHEOTOMY IN THE 1ST YEAR OF LIFE [J].
GIANOLI, GJ ;
MILLER, RH ;
GUARISCO, JL .
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 1990, 99 (11) :896-901
[9]  
GOLDSMITH MM, 1987, LARYNGOSCOPE, V97, P851
[10]  
HAWKINS DB, 1984, LARYNGOSCOPE, V94, P633