title: Isolated subglottic hemangiomas: A potential diagnostic challenge in the absence of a cutaneous clue.
abstract: OBJECTIVE
  Subglottic hemangiomas may present a diagnostic challenge in the stridorous infant without a cutaneous lesion.
  
  
  METHODS
  Consecutive case series with chart review of isolated subglottic hemangiomas without cutaneous lesions.
  
  
  RESULTS
  Two patients with isolated subglottic hemangiomas without cutaneous lesions were identified. Both patients presented with stridor and were initially treated with systemic corticosteroids, racemic epinephrine, and supportive medical therapy for a presumed infectious etiology. After failure to clinically improve over an expected period of time, endoscopy was performed. Propranolol was initiated immediately after the diagnosis was made. Clinical response was noted in the first 24 hours after administration. Both children were able to be safely titrated up to the therapeutic dose (2mg/kg/day). No complications or re-admissions were encountered.
  
  
  CONCLUSIONS
  Clinical suspicion for a subglottic hemangioma in an infant with stridor may be high in cases where there is a synchronous cutaneous lesion. In infants without cutaneous involvement, diagnosis may be delayed and more challenging, given the possibility of an infectious etiology. These infants without a synchronous cutaneous lesion tend to present at an older age than infants with cutaneous lesions and may be managed successfully with propranolol.
authors: Division of Pediatric Otolaryngology, Cohen Children's Medical Center, New Hyde Park, NY, USA; Department of Otolaryngology - Head and Neck Surgery, Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA. Electronic address: jcheng2@nshs.edu.
authors: Jeffrey
authors: J
authors: Cheng
mesh_terms: D005931:Glottis; D006391:Hemangioma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007223:Infant; D007822:Laryngeal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D007828:Laryngoscopy; D008297:Male; D011433:Propranolol / Q000627:therapeutic use; D012135:Respiratory Sounds / Q000209:etiology; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D011433:Propranolol