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Original Research

Open Access

Subglottic hemangioma—prevalence, clinical presentation and treatment

  • Mihail Basa1
  • Predrag Minic1,2
  • Bojana Gojsina1
  • Aleksandar Sovtic1,2,*,

1Department of Pulmonology, Mother and Child Health Care Institute of Serbia, 11000 Belgrade, Serbia

2School of Medicine, University of Belgrade, 11000 Belgrade, Serbia

DOI: 10.22514/sv.2023.095 Vol.19,Issue 6,November 2023 pp.38-42

Submitted: 05 November 2022 Accepted: 13 February 2023

Published: 08 November 2023

*Corresponding Author(s): Aleksandar Sovtic E-mail: aleksandar.sovtic@med.bg.ac.rs

Abstract

This retrospective study aimed to investigate the clinical features and treatment of pediatric subglottic hemangioma (SH), identify risk factors for treatment-induced adverse effects, and identify a strategy for timely therapy discontinuation in children diagnosed with SH at the national pediatric center. Medical records of patients presented with stridor from 2010 to 2020 were retrieved and assessed, the diagnosis of SH was established via flexible bronchoscopy, and the patients were treated using propranolol with a subsequent gradual dose increase to 3 mg/kg body weight daily. A two-week oral steroids trial was added for those with circumferential lesions. Early indicators of a good therapeutic response included decreased stridor and primary lesion size on follow-up bronchoscopy performed one week after propranolol commencement. Duration of therapy, tailored individually based on bronchoscopy findings, and at least twelve months of treatment were the two main criteria for deciding therapy termination. Outpatient visits were arranged at least every three months. Our results showed that SH was the third most frequent cause of stridor (15/137 patients), and biphasic stridor was uniformly present as a typical symptom. Both clinical improvement and bronchoscopy findings confirmed the efficacy of the treatment. The mean therapy duration was 17 months. The only significant adverse event observed was hypoglycemic seizures in one infant. Contributory factors were all prematurity, high propranolol dose (3 mg/kg) and poor oral intake. Collectively, defining a safe and timely protocol for therapy cessation and avoidance of risk factors for adverse effects is the mainstay of SH treatment.


Keywords

Subglottic hemangioma; Propranolol; Hypoglycemic seizures


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Mihail Basa,Predrag Minic,Bojana Gojsina,Aleksandar Sovtic. Subglottic hemangioma—prevalence, clinical presentation and treatment. Signa Vitae. 2023. 19(6);38-42.

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