Systemic steroids for the management of obstructive subglottic hemangioma.
Subglottic hemangioma is a recognized cause of paediatric upper airway obstruction. We present 14 patients with subglottic hemangioma treated between 1984 and 1997,4 of whom had associated extralaryngeal hemangiomatous lesions (28%). The degree of upper airway obstruction ranged between 20% and 90%. Patients with subglottic hemangioma who had obstruction of the laryngeal lumen more than 25% and those with obstructive symptoms were treated with systemic steroids. The patients were followed clinically, radiographically, and with repetitive bronchoscopies. Nine of 10 patients (90%) have responded clinically to systemic steroids. There were no major complications from the systemic steroid treatment. One patient developed a cushingoid face that was reversed after the cessation of steroid therapy. The purpose of this study is to show that systemic steroids, with or without short-term intubation after diagnostic bronchoscopy, can be used as a safe and effective alternative in the management of obstructive paediatric subglottic hemangiomas.
Al-Sebeih
K
K
Department of Otolaryngology, Montreal Children's Hospital, McGill University, Quebec.
Manoukian
J
J
D000402:Airway Obstruction / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006391:Hemangioma / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007822:Laryngeal Neoplasms / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D011239:Prednisolone