Treatment of subglottic hemangiomas with propranolol: initial experience in 10 infants
Subglottic hemangiomas (SGH) are a rare tumour, often associated with significant airway obstruction in infants. Current treatment options, while effective, often expose the infant to potential complications. Emerging evidence suggests a role for the beta blocker propranolol in the initial management of SGH.We report our experience with propranolol 2 mg/kg/day in 10 consecutive cases of SGH with significant airway obstruction (age range 2–4 months).After a mean of 7.7 months of treatment, symptom resolution was observed in all cases and eight infants had regression and were stable. Two patients experienced regrowth after 9 months of therapy. To date, no infant has had a tracheostomy or surgical removal of the lesion.Early results with propranolol are promising; it is effective in controlling SGH, has a rapid onset of action, appears to obviate the need for tracheostomy and can allow tapering of the corticosteroid dose. Repeat laryngoscopy will be required to map the clinical course of these children and elucidate the long-term benefits of propranolol.