Efficacy of intralesional steroid injection in head and neck hemangioma: a systematic review.
BACKGROUND
The purpose of this article was to discuss about the use of corticosteroids in head and neck hemangioma as one of the safest noninvasive therapy, focusing on intralesional steroid injection, including perilesional and infusion, for curing or reducing tumor size.


METHODS
A systematic review was done by means of all English publication in PubMed during the period of 1996 to 2008 using the keywords "hemangioma" and "intralesional steroid injection." The studies involved were retrospective and prospective case reviews on using intralesional steroid injection with or without other treatment modalities. Exclusion criteria included letter to the editor, comment, and discussion. Evaluation was done covering the indication, age and sex of the patients, location of the lesion, reduction in volume and resolution after intralesional steroid injection, including perilesional and infusion, the improvement of symptoms and signs, local and systemic complications, dose, and the number of injections required to achieve the desired clinical and aesthetic results.


RESULTS
Using the 7th ed. EndNote program, 81 abstracts were successfully retrieved. Finally, this study limited our analysis to 22 studies. A total of 749 patients received intralesional steroid injections, including perilesional and infusion, with or without other treatment modalities. Age of the participants ranged from 10 days to 4 years (mean, 4.17 months). Six references evaluated the percentage of reduction in volume and size after intralesional steroid injection; 71% revealed excellent clinical response, 23.4% good, 2.96% poor, 2% no response, and 0.6% were lost to follow-up. From the remaining, 82% of the participants revealed improvement in sign and symptoms. Three articles mentioned aesthetic evaluation, and all stated excellent to good outcome.


CONCLUSIONS
Intralesional steroid injection is a good option for treating head and neck hemangioma at proliferative phase with relatively low complications.
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia. teddyohprasetyono@yahoo.com
Theddeus O H
TO
Prasetyono
Intania
I
Djoenaedi
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015552:Injections, Intralesional; D008297:Male
D000305:Adrenal Cortex Hormones