title: Office-Based Subglottic Evaluation in Children With Risk of Subglottic Hemangioma.
abstract: OBJECTIVE
  Children with V3 cutaneous infantile hemangiomas (IH) and PHACE syndrome have a high incidence for airway hemangioma, 29% and 52%, respectively. Therefore, a clinical evaluation for these high-risk children is essential. We report our experience with in-office lower airway evaluation (OLAE) in these high-risk children.
  
  
  RESULTS
  Since 2003, 5 children with IH of the V3 cutaneous distribution and 3 children with PHACE syndrome underwent OLAE. Average age of presentation was 2.75 months. Two children had stridor at initial evaluation, and 1 child had subglottic hemangioma. This child was evaluated serially with OLAE to monitor disease progression and treatment response. A total of 10 upper tracheoscopies were performed on the 8 patients without respiratory complications.
  
  
  CONCLUSIONS
  An airway evaluation is essential to evaluate and manage this high-risk population. Typically, operative endoscopy requires general anesthesia. However, in these high-risk children, we have performed OLAE without sedation to evaluate the trachea. High-speed recording and playback is essential in this method. Our series demonstrates that awake OLAE is possible and may be a safe technique to evaluate and monitor disease progression in these high-risk patients. These patients avoided general anesthesia and delay in diagnosis and did not incur any complications during or after OLAE.
authors.affiliation: Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA rchun@mcw.edu.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Chun
authors.affiliation: Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: McCormick
authors.affiliation: Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Martin
authors.affiliation: Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Drolet
authors.affiliation: Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kerschner
mesh_terms: D000553:Ambulatory Care; D001017:Aortic Coarctation / Q000453:epidemiology; D001999:Bronchoscopy; D015331:Cohort Studies; D015897:Comorbidity; D005124:Eye Abnormalities / Q000453:epidemiology; D005153:Facial Neoplasms / Q000453:epidemiology; D005260:Female; D005931:Glottis; D006391:Hemangioma / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D007828:Laryngoscopy; D008297:Male; D020752:Neurocutaneous Syndromes / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology; D014134:Tracheal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology
keywords: PHACE; bronchoscopy; infantile hemangioma; office-based procedure; propranolol; subglottic hemangioma