[Severe subglottic hemangioma in the infant: corticotherapy, intubation or surgery?].
In the case of sub-glottic hemangioma, with serious immediate or cortico-resistant dyspnea, it is not always possible to wait for the growth of the laryngo-tracheal skeleton and the spontaneous involution of the angioma. On the basis of a series of 25 cases, we propose in these serious forms the following therapeutic escalation: very high dose corticotherapy, with betamethasone at 0.12 to 0.48 mg/kg/day for 15 days, followed by a degressive treatment over 6 weeks to 3 months; intubation to overcome a difficult stage in the event of aggravation of the angioma with a rhinopharyngitis. Embolization and the use of the laser proved unsatisfactory in the extensive forms of angiomas. In the event of failure of the preceding treatment, we perform a tracheotomy, the duration of which can be reduced by the surgical exeresis of the angioma with a widening of the larynx.
Zohair
A
A
Hôpital Robert Debré, Faculté Xavier Bichat, Clinique O.R.L., Paris, France.
François
M
M
Polonovski
J M
JM
Narcy
P
P
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D004621:Embolization, Therapeutic; D005260:Female; D006391:Hemangioma / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D007822:Laryngeal Neoplasms / Q000601:surgery / Q000628:therapy*; D007829:Laryngostenosis / Q000628:therapy; D053685:Laser Therapy; D008297:Male; D014140:Tracheotomy
D000305:Adrenal Cortex Hormones
Hémangiomes sous-glottiques graves du nourrisson: corticothérapie, intubation ou chirurgie?