Propranolol in the therapeutic strategy of infantile laryngotracheal hemangioma: A preliminary retrospective study of French experience.
OBJECTIVE
Preliminary assessment of the efficacy of propranolol on subglottic hemangioma in children on a nation-wide scale.


METHODS
Multicentric, retrospective study of clinical files of 14 children; pre- and post-treatment endoscopies.


RESULTS
Mean age at diagnosis was 2.3 (0.7-4) months. Mean percentage of airway obstruction was 68% (15-90) before propranolol introduction. Propranolol was started at 5.2 (0.7-16) months of age. This treatment was effective in all cases with a mean regression of the stenosis to 22% after 2 weeks and 12% after 4 weeks. Other medical treatments (steroids) could be stopped. In one patient, a side effect of propranolol motivated the switch to another β-blocker. In four patients, treatment was stopped after 5.2 (1-10) months with a relapse in 2 (50%) cases. One of these two patients developed a resistance to propranolol and required a surgical procedure by external approach.


CONCLUSIONS
This preliminary nation-wide survey confirms propranolol high effectiveness against airways' localization of infantile hemangiomas. Propranolol also allows alleviation or cut-off of previous medical treatments. However, recurrences are possible after early treatment interruption.
Leboulanger
Nicolas
N
Hôpital Armand-Trousseau, 75012 Paris, France. nicolas.leboulanger@trs.aphp.fr
Fayoux
Pierre
P
Teissier
Natacha
N
Cox
Amanda
A
Van Den Abbeele
Thierry
T
Carrabin
Laure
L
Couloigner
Vincent
V
Nicollas
Richard
R
Triglia
Jean-Michel
JM
Ayari
Sonia
S
Froehlich
Patrick
P
Lescanne
Emmanuel
E
Marianowski
Rémy
R
Mom
Thierry
T
Mondain
Michel
M
Marie
Jean-Paul
JP
Roger
Gilles
G
Garabédian
Eréa-Noël
EN
Denoyelle
Françoise
F
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000402:Airway Obstruction / Q000188:drug therapy / Q000209:etiology; D004351:Drug Resistance; D006391:Hemangioma / Q000151:congenital / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007822:Laryngeal Neoplasms / Q000151:congenital / Q000188:drug therapy*; D011433:Propranolol / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D014134:Tracheal Neoplasms / Q000151:congenital / Q000188:drug therapy*
D000319:Adrenergic beta-Antagonists; D011433:Propranolol