Treatment of infantile subglottic hemangioma by microdebrider

Abstract

To investigate the clinical features, minimally invasive treatment, and outcomes of subglottic hemangioma in infants. Fifteen cases of infantile subglottic hemangioma treated from January 2009 to December 2012 were retrospective analysed. Average time of onset was within 43 days-5 months of age. Seven cases had symptoms of laryngeal obstruction one week after birth, and 8 cases had symptoms within three weeks to six weeks after birth. Fourteen cases were unilateral and 1 case bilateral. No case had tracheotomy. Seven cases were hospitalised after intubation. Of which 5 cases with subglottic hemangiomas who failed to respond to pharmacologic treatment were treated by microdebrider under suspension laryngoscope. Ten cases accepted suction cutter suction. After surgery, nine cases were confirmed pathologically as capillary hemangioma. Average bleeding was 1-3 ml during operation, surgery usually lasted 10-15 minutes. No complications were found. Five cases required orotracheal intubation for 24 or 48 h after surgery, and no reintubation or tracheotomy was required in this series. Symptoms such as stridor and inspiratory retraction resolved approximately 12-72 h after surgery. Follow-up was 12-18 months after surgery, no systemic or local complications were observed, and no recurrence. The treatment of subglottic hemangioma is individualised. If the tracheal stenoses ≥ 50%, with recurrent infection and acute laryngeal obstruction, removal of tumor with microdebrider is the minimally invasive, safe, simple and effective method with less complications. It is important that the anaesthetist should work well with otolaryngologist during operation.