Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-08T10:31:25.973Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of propranolol to treat multicentric airway haemangioma

Published online by Cambridge University Press:  07 April 2010

N Mistry  and
K Tzifa
N Mistry
Affiliation:
Department of Otolaryngology, Birmingham Children's Hospital, UK
K Tzifa*
Affiliation:
Department of Otolaryngology, Birmingham Children's Hospital, UK
*
Address for correspondence: Mrs K Tzifa, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To report our experience of using propranolol to treat an infantile airway haemangioma.

Methods:

A five-week-old girl presented with upper airway obstruction. Having started systemic steroids, concurrent propranolol therapy was commenced. Propranolol was given with close monitoring of the blood pressure, pulse and capillary glucose level. The dose of propranolol was gradually increased to 2 mg/kg total daily dose, with simultaneous reduction and withdrawal of steroids.

Results:

Prior to propranolol treatment, laryngotracheobronchoscopy revealed an extensive haemangioma extending from the posterior pharyngeal wall to the subglottis. Following initiation of propranolol, a dramatic reduction in tumour bulk was seen on repeated laryngotracheobronchoscopy within 10 days of treatment. Eight months on, the patient remained asymptomatic on propranolol, with no endoscopic evidence of disease apart from mild telangiectasia.

Conclusion:

Haemangiomas of the airway can cause obstruction which may potentially be life-threatening. This case demonstrates the potential of propranolol to become a valuable therapeutic option in such clinical situations.

Keywords

Subglottic HaemangiomaInfantile HaemangiomaPropranolol
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 12 , December 2010 , pp. 1329 - 1332
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the ENT UK Conference, 11 September 2009, London, and the Annual Scientific & General Meeting of the British Association for Paediatric Otorhinolaryngology, 18 September 2009, Manchester, UK.

References

1O-Lee, TJ, Messner, A. Subglottic haemangioma. Otolaryngol Clin North Am 2008;41:903–11CrossRefGoogle Scholar
2Saetti, R, Silvestrini, M, Cutrone, C, Narne, S. Treatment of congenital subglottic haemangiomas. Arch Otolaryngol Head Neck Surg 2008;134:848–51CrossRefGoogle Scholar
3Al-Sebeih, K, Manoukian, J. Systemic steroids for the management of obstructive subglottic hemangioma. J Otolaryngol 2000;29:361–6Google ScholarPubMed
4Léauté-Labrèze, C, Dumas de la Roque, E, Hubiche, T, Thambo, JB, Taïeb, A. Propranolol for severe haemangiomas of infancy. N Engl J Med 2008;358:2649–51CrossRefGoogle ScholarPubMed
5Rahbar, R, Nicollas, R, Roger, G, Triglia, J-M, Garabedian, E-N, McGill, TJ et al. The biology and management of subglottic haemangioma: past, present and future. Laryngoscope 2004;114:1880–91CrossRefGoogle Scholar
6Bailey, CM, Froehlich, P, Hoeve, HL. Management of subglottic haemangioma. J Laryngol Otol 1998;112:765–8CrossRefGoogle ScholarPubMed
7Bitar, MA, Mourkarbel, RV, Zalzal, GH. Management of congenital subglottic hemangioma: trends and success over the past 17 years. Otolaryngol Head Neck Surg 2005;132:226–31CrossRefGoogle ScholarPubMed
8George, ME, Sharma, V, Jacobson, J, Simon, S, Nopper, AJ. Adverse effects of systemic glucocorticosteroid therapy in infants with hemangiomas. Arch Dermatol 2004;140:963–9CrossRefGoogle ScholarPubMed
9Suehs, OW, Herbur, PA. Hemangiomas of the larynx in infants. Arch Otolaryngol 1940;32:783–9CrossRefGoogle Scholar
10Healy, G, McGill, T, Friedman, EM. Carbon dioxide laser in subglottic hemangioma. An update. Ann Otol Rhinol Laryngol 1984;93:370–3CrossRefGoogle ScholarPubMed
11Brodsky, L, Yoshpe, N, Ruben, RJ. Clinical-pathological correlates of congenital subglottic hemangiomas. Ann Otol Rhinol Laryngol 1983;105:4–18Google ScholarPubMed
12Chatrath, P, Black, M, Jani, P, Albert, DM, Bailey, CM. A review of the current management of infantile subglottic haemangioma, including a comparison of CO2 laser therapy versus tracheostomy. Int J Pediatr Otorhinolaryngol 2002;64:143–57CrossRefGoogle ScholarPubMed
13Sharp, HS. Haemangioma of the trachea in an infant; successful removal. J Laryngol Otol 1949;63:413CrossRefGoogle Scholar
14Denoyelle, F, Leboulanger, N, Enjolras, O, Harris, R, Roger, G, Garabedian, EN. Role of propranolol in the therapeutic strategy of infantile laryngotracheal hemangioma. Int J Pediatr Otorhinolaryngol 2009;73:1168–72CrossRefGoogle ScholarPubMed
15Buckmiller, L, Dyamenahalli, U, Richter, GT. Propranolol for airway hemangiomas: case report of novel treatment. Laryngoscope 2009;119:2051–4CrossRefGoogle ScholarPubMed
16Siegfried, EC, Keenan, WJ, Al-Jureidini, S. More on propranolol for hemangiomas of infancy. N Engl J Med 2008;359:2846–7Google ScholarPubMed