title: Treatment of subglottic hemangiomas with propranolol: initial experience in 10 infants.
abstract: BACKGROUND
  Subglottic hemangiomas (SGH) are a rare tumour, often associated with significant airway obstruction in infants. Current treatment options, while effective, often expose the infant to potential complications. Emerging evidence suggests a role for the beta blocker propranolol in the initial management of SGH.
  
  
  METHODS
  We report our experience with propranolol 2 mg/kg/day in 10 consecutive cases of SGH with significant airway obstruction (age range 2–4 months).
  
  
  RESULTS
  After a mean of 7.7 months of treatment, symptom resolution was observed in all cases and eight infants had regression and were stable. Two patients experienced regrowth after 9 months of therapy. To date, no infant has had a tracheostomy or surgical removal of the lesion.
  
  
  CONCLUSIONS
  Early results with propranolol are promising; it is effective in controlling SGH, has a rapid onset of action, appears to obviate the need for tracheostomy and can allow tapering of the corticosteroid dose. Repeat laryngoscopy will be required to map the clinical course of these children and elucidate the long-term benefits of propranolol.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Starship Children’s Hospital, Auckland, New Zealand. surgeon@entdoctor.co.nz
authors.forename: Murali
authors.initials: M
authors.lastname: Mahadevan
authors.forename: Alan
authors.initials: A
authors.lastname: Cheng
authors.forename: Colin
authors.initials: C
authors.lastname: Barber
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis; D006391:Hemangioma / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D007828:Laryngoscopy; D008297:Male; D009367:Neoplasm Staging; D011433:Propranolol / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol