Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-19T00:14:56.234Z Has data issue: false hasContentIssue false

Management of subglottic haemangioma

Published online by Cambridge University Press:  29 June 2007

C. Martin Bailey*
Affiliation:
Department of Otolaryngology, Great Ormond Street Hospital for Children, London, UK.
Patrick Froehlich
Affiliation:
Department of Otolaryngology, Hôpital E. Herriot, Lyon, France.
Hans L. J. Hoeve
Affiliation:
Department of Otolaryngology, Sophia Children's Hospital, Rotterdam, The Netherlands.
*
Address for correspondence: Mr C. Martin Bailey B.Sc., F.R.C.S., Consultant Otolaryngologist, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH. U.K.

Abstract

Two contrasting methods of treatment for paediatric subglottic haemangioma are presented. Dr. Hoeve describes his results using intralesional steroids and short-term intubation, and Dr. Froehlich discusses his outcomes with open surgical excision. Mr. Bailey then reviews the currently available therapeutic options with special reference to each of the above techniques, and suggests an optimum plan of management given our current state of knowledge.

The conclusion is that very small haemangiomas may not require treatment, or may be amenable to CO2 laser vaporization. Medium-sized lesions seem suitable for intra-lesional steroids and intubation, but large ones are probably best managed by primary submucous resection. Very large haemangiomas, and especially those which are circumferential or in which magnetic resonance imaging (MRI) shows extension down into the trachea and/or through the tracheal wall into the surrounding tissues, may be more safely dealt with by performing a tracheostomy and awaiting spontaneous involution.

Type
‘Second Opinion’ Article
Copyright
Copyright © JLO (1984) Limited 1998

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.)

References

Choa, D. I., Smith, M. C. F., Evans, J. N. G., Bailey, C. M. (1986) Subglottic haemangioma in children. Journal of Laryngology and Otology 100: 447454.CrossRefGoogle ScholarPubMed
Ferguson, C. F., Flake, C. G. (1961) Subglottic haemangioma as a cause of respiratory obstruction in infants. Annals of Otology, Rhinology and Laryngology 70: 10951112.Google Scholar
Hoeve, L. J., Kuppers, G. L. E., Verwoerd, C. D. A. (1997) Management of infantile subglottic hemangioma: laser vaporization, submucous resection, intubation, or intralesional steroids. International Journal of Pediatric Otorhinolaryngology 42: 179186.CrossRefGoogle ScholarPubMed
Narcy, P., Contencin, P., Bobin, S., Manac'h, Y. (1985) Treatment of infantile subglottic haemangioma. A report of 49 cases. International Journal of Pediatric Otorhinolaryngology 9: 157164.CrossRefGoogle ScholarPubMed
Ohlms, L. A., Jones, D. T., McGill, T. J., Healy, G. B. (1994) Interferon alfa-2a therapy for airway hemangiomas. Annals of Otology, Rhinology and Laryngology 103: 18.Google Scholar
Sebastian, B., Kleinsasser, O. (1984) Zur Behandlung der Kehlkopfhamangiome bei Kindern. Laryngologie, Rhinologie und Otologie (Stuttgart) 63: 403407.CrossRefGoogle Scholar
Sharp, H. S. (1949) Haemangioma of the trachea in an infant, successful removal. Journal of Laryngology and Otology 63: 413414.CrossRefGoogle Scholar
Sie, K. C. Y., McGill, T., Healy, G. B. (1994) Subglottic hemangioma: ten years' experience with the carbon dioxide laser. Annals of Otology, Rhinology and Laryngology 103: 167172.Google Scholar
Verwoerd-Verhoef, H. L., Adriaansen, F. C. P. M., Laeijendecker, R. J., Van Osch, G. J. V. M., Verwoerd, C. D. A. (1997) Growth dynamics of the cricoid cartilage and subglottic injury. An autoradiographic and histometric study in the rabbit. European Archives of Otorhinolaryngology 254: S101S104.CrossRefGoogle ScholarPubMed
Wiatrak, B. J., Reilly, J. S., Seid, A. B., Pransky, S. M., Castillo, J. V. (1996) Open surgical excision of subglottic hemangioma in children. International Journal of Pediatric Otorhinolaryngology 34: 191206.CrossRefGoogle ScholarPubMed