title: Clinical Outcomes of Infants With Periorbital Hemangiomas Treated With Oral Propranolol.
abstract: OBJECTIVE
  Periorbital infantile hemangiomas (IHs) require early intervention because they have the potential risk of causing visual disturbances. In recent years, propranolol has shown promise in the effective management of periocular and periorbital IHs. The objective of our study was to assess the clinical outcomes, efficacy, and safety of propranolol in the management of infants with high-risk periorbital IHs.
  
  
  METHODS
  This retrospective study was conducted at the Stomatological Hospital affiliated with China Medical University. The medical records of infants with periorbital hemangiomas who were treated with systemic propranolol at a dose of 1.0 to 1.5 mg/kg per day between January 2014 and June 2015 were reviewed. We excluded infants who did not qualify for propranolol treatment and infants who received previous therapy or other treatments. The records were reviewed for treatment response, adverse events during treatment, length of treatment, and recurrences. Treatment response was classified using a 4-point scale system based on reduction in volume as poor (<25%), moderate (25 to 50%), good (50 to 75%), or excellent (>75 to 100%) and change in color, as well as surface texture, by a panel of 3 plastic surgeons using 2-dimensional photographs, clinical examination, and Doppler ultrasonography measurements taken before and after treatment.
  
  
  RESULTS
  Of 38 infants with periorbital hemangiomas, 26 were treated with systemic propranolol at a dose of 1.0 to 1.5 mg/kg administered once daily. A total of 11 male and 15 female infants with a mean age of 5.2 months (range, 2 to 12 months) were treated. The mean length of treatment was 22 weeks (range, 4 to 41 weeks). Adverse events of diarrhea (n = 3) and sleep changes (n = 1) were encountered during treatment in 4 patients. The overall treatment response was scored as excellent in 17 patients, good in 7, moderate in 2, and poor in 0. No patients required discontinuation of treatment because of adverse events, and there were no cases of recurrence or tumor regrowth noted during the mean follow-up period of 6.5 months (range, 3 to 10 months).
  
  
  CONCLUSIONS
  Oral propranolol at a dose of 1.0 to 1.5 mg/kg per day (age ≤3 months, 1.0 mg/kg; age >3 months, 1.5 mg/kg) was effective and well tolerated for the management of 26 Chinese infants with high-risk periorbital IHs. Early intervention should be considered to reduce risk of visual impairment and improve esthetic outcomes.
authors.affiliation: Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xue
authors.affiliation: Attending Surgeon, Department of Oral and Maxillofacial Surgery, Yantai Stomatological Hospital, Yantai, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Sun
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Yantai Stomatological Hospital, Yantai, China.
authors.forename: Da-Peng
authors.initials: DP
authors.lastname: Xu
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.
authors.forename: Zi-Mei
authors.initials: ZM
authors.lastname: Liu
authors.affiliation: Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China. Electronic address: wangxukai757892@sina.com.
authors.forename: Xu-Kai
authors.initials: XK
authors.lastname: Wang
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005123:Eye; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011433:Propranolol / Q000627:therapeutic use*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol