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Management of subglottic haemangioma

Published online by Cambridge University Press:  29 June 2007

C. Martin Bailey*
Affiliation:
Department of Otolaryngology, Great Ormond Street Hospital for Children, London, UK.
Patrick Froehlich
Affiliation:
Department of Otolaryngology, Hôpital E. Herriot, Lyon, France.
Hans L. J. Hoeve
Affiliation:
Department of Otolaryngology, Sophia Children's Hospital, Rotterdam, The Netherlands.
*
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.

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.

Type
‘Second Opinion’ Article
Copyright
Copyright © JLO (1984) Limited 1998

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