Role of propranolol in ulcerated haemangioma of head and neck: a prospective comparative study.
OBJECTIVE
Infantile haemangiomas comprise the majority of vascular anomalies and are considered the predominant vascular tumour type 1. We performed this prospective study to evaluate the therapeutic response and propranolol tolerance in infants with ulcerated infantile haemangioma of head and neck region.


METHODS
Sixty-four patients with ulcerated infantile haemangiomas (IHs) of head and neck region, without any prior treatment and with age older than 1 month, were included in the study, after informed consent was obtained, and were randomly divided into groups A and B. Group A patients were given oral propranolol at a dose of 2 mg/kg per day in three divided doses as outpatients. Group B patients were given oral ibuprofen at a dose of 10 mg/kg 8-hourly and paracetamol at dose of 16.2 mg/kg 8-hourly. Documentation of gender, age, haemangioma location, duration of ulceration and pain was measured on the second and fifth day after commencement of treatment in both groups using the Children's Hospital of Eastern Ontario Pain Scale.


RESULTS
There was no difference in pain score between the two groups (P value 0.074). Mean duration of healing of ulceration in group A was 17.93 ± 2.22 days and in group B was 27.71 ± 2.33 days (P value <0.001). In group A, out of 28 patients, 8 (28.5 %) were complete responders, 16 (57.1 %) were partial responders and 4 (14.2 %) were non-responders.


CONCLUSIONS
Propranolol is a valuable therapeutic alternative for treatment of ulcerated haemangiomas and effectively reduces pain.
Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, IMS, BHU, Varanasi, India. drtiwaripreeti@gmail.com.
Preeti
P
Tiwari
Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, IMS, BHU, Varanasi, India.
Vaibhav
V
Pandey
Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, IMS, BHU, Varanasi, India.
Ajay N
AN
Gangopadhyay
Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, IMS, BHU, Varanasi, India.
Shiv P
SP
Sharma
Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, IMS, BHU, Varanasi, India.
Dinesh K
DK
Gupta
D000082:Acetaminophen / Q000627:therapeutic use*; D000284:Administration, Oral; D004359:Drug Therapy, Combination; D005260:Female; D006258:Head and Neck Neoplasms / Q000151:congenital* / Q000188:drug therapy*; D006391:Hemangioma / Q000151:congenital* / Q000188:drug therapy*; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D010147:Pain Measurement / Q000187:drug effects; D011433:Propranolol / Q000627:therapeutic use*; D011446:Prospective Studies; D012883:Skin Ulcer / Q000151:congenital* / Q000188:drug therapy*; D014945:Wound Healing / Q000187:drug effects
D000082:Acetaminophen; D011433:Propranolol; D007052:Ibuprofen
Complicated haemangioma; Haemangioma; Infantile; Propranolol; Ulcerated haemangioma