Treatment for infantile subglottic hemangioma with oral propranolol

Abstract

Objective:To investigate the clinical characteristics of infantile subglottic hemangioma（SGH）, and to observe the safety and efficacy of propranolol in the treatment of SGH. Methods:The data of 13 children diagnosed with SGH and treated with propranolol in Shanghai Children's Hospital from November 2015 to March 2020 were retrospectively analyzed and followed up. All 13 cases underwent laryngoscopy and 10 cases underwentcontrastenhanced CT. Laryngeal exploration under general anesthesia was performed in 2 cases. Propranolol was started at 1 mg/（kg·d） divided into 3 doses. Heart rate and blood pressure were monitored during treatment. If no side effects were observed, then the dose was increased to 1.5 mg/（kg·d） on the second day. It was suggested to maintain this starting dose at diagnosis（1.5 mg/kg body weight）, and not increase the number of milligrams as the child gained weight. Results:The age at therapy termination ranged from 9 months to 38 months, only 2 cases beyond 2 years old, with an average of （19.3±7.7） months. The treatmentduration ranged from 6 to 21.3 months, with an average of （13.3±4.9） months. The follow-up time ranged from 21 to 71 months, with an average of （46.8±14.9） months. All 13 cases were cured. Conclusion:Infants under 2 years old with stridor have poor effect or repeated condition after routine treatment, SGH should be considered at this moment. Laryngoscopy combined with contrastenhanced CT is recommended. Oral propranolol is safe and effective in the treatment of SGH. It is suggested to oral propranololbeyond 19 months old to reduce recurrence, furthermore, 2 years old may be the best time for therapy termination.