Management of congenital subglottic hemangioma: trends and success over the past 17 years.
OBJECTIVE
To evaluate the success and complications of various treatment options of congenital subglottic hemangioma.


METHODS
Reported cases were grouped by treatment modalities and corresponding outcome evaluated.


RESULTS
From 1986 through 2002, 372 patients were reported in 28 series. Carbon dioxide laser had 88.9% success rate yet 5.5 % significant subglottic stenosis. It shortened the tracheotomy duration by 13.7 months. Corticosteroids were not that beneficial (useful in only 24.5%) with 12.9% side effects. Intralesional corticosteroids were successful in 86.4% with 5.6% complication rate. Surgical excision (as young as 2.5 months), was useful in 98% with 10% complication rate, using cartilage grafts in 34%. Other modalities were less popular.


CONCLUSIONS
Treatment should be individualized. Guidelines are suggested. Priority is given to secure the airways. The CO 2 laser is useful when used cautiously. Steroids may be beneficial. Excision is for stubborn cases.
Bitar
Mohamed A
MA
Department of Otolaryngology-Head and Neck Surgery, American Univeristy of Beirut Medical Center, American University of Beirut School of Medicine, Lebanon. mb36@aub.edu.lb
Moukarbel
Roger V
RV
Zalzal
George H
GH
D002675:Child, Preschool; D005260:Female; D005931:Glottis / Q000601:surgery*; D006391:Hemangioma / Q000151:congenital* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007822:Laryngeal Neoplasms / Q000151:congenital* / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000639:trends*; D016896:Treatment Outcome