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Failure of propranolol in the treatment of childhood haemangiomas of the head and neck

Published online by Cambridge University Press:  16 August 2011

J Goswamy ,
M P Rothera  and
I A Bruce
J Goswamy*
Affiliation:
Department of Paediatric Otorhinolaryngology, Royal Manchester Children's Hospital, UK
M P Rothera
Affiliation:
Department of Paediatric Otorhinolaryngology, Royal Manchester Children's Hospital, UK
I A Bruce
Affiliation:
Department of Paediatric Otorhinolaryngology, Royal Manchester Children's Hospital, UK Honorary Senior Lecturer, The University of Manchester, UK
*
Address for correspondence: Mr J Goswamy, Department of Paediatric Otorhinolaryngology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK E-mail: jaygoswamy@doctors.org.uk
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Abstract

Background:

Infantile haemangiomas enter a rapid proliferative phase within months of birth, before slowly involuting. Those with the potential for disfigurement or morbidity require intervention. Propranolol has emerged as an effective new treatment modality, with the potential to become the first-line treatment of choice.

Methods:

Four children with haemangiomas of the head and neck were treated with propranolol at a tertiary referral centre. The size of the haemangioma and the symptoms resulting from airway compromise were monitored.

Results:

Three of the four children showed a dramatic response to treatment with propranolol. However, one child responded initially but was readmitted with stridor secondary to new haemangioma proliferation.

Conclusions:

We report a cautionary case in which a subglottic haemangioma developed contemporaneously with propranolol treatment, requiring surgical intervention. This finding highlights the need for regular follow up of treatment response, and the need for monitoring for treatment side effects.

Keywords

InfanthemangiomasCongenitalLarynxNoseFacePropranolol
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 11 , November 2011 , pp. 1164 - 1172
Copyright
Copyright © JLO (1984) Limited 2011

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Footnotes

Presented at the 138th Semon Club Meeting, 20 November 2009, London, UK

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