Subglottic hemangioma in infants.

Abstract

AbstractA series of seven cases of subglottic hemangioma in infants ranging in age from three weeks to 18 months is being presented. These cases were treated between 1958 and 1972. There was no sexual preponderance, four cases being male and three female. All cases presented with severe upper respiratory obstruction requiring immediate tracheoscopy and tracheotomy. Two cases presented with simultaneous cutaneous hemangiomata of the back. Careful post‐tracheotomy observation is stressed to insure adequate pulmonary ventilation. Repeat bronchoscopy for aspiration of retained secretions and removal of a polyp at the tracheostomy was necessary in one case. Blood gas analysis for PCO2 and Po2 to determine extent of chronic hypoxia is recommended; also chest X‐rays may reveal evidence of cardio‐megaly, especially of the right ventricle as seen in chronic pulmonary hypertension secondary to alveolar hypoventilation.Gradual involution of the hemangioma after 12 months of age is to be expected. In those cases with associated cutaneous lesions, the resolution of the skin lesion may be used as a guide to determine the extent of resolution of the tracheal lesions. Lateral X‐rays of the trachea and barium studies of the upper esophagus are helpful to demonstrate the extent of the subglottic mass and also the degree of involvement of the party wall between the esophagus and trachea.One dose of radiotherapy was administered in only one case.Careful repeat tracheoscopy is recommended prior to decannulation to insure an adequate airway. Cortico‐steroids and cryotherapy were not used in these cases.All infants survived, and two of the more recent cases have not been de‐cannulated to date.