Pransky Seth M, Canto Cecilia
Department Pediatric Otolaryngology and Head-Neck Surgery, San Diego Children's Hospital, San Diego, California 92123, USA.
Curr Opin Otolaryngol Head Neck Surg. 2004 Dec;12(6):509-12. doi: 10.1097/01.moo.0000143980.41120.38.
Subglottic hemangioma is a challenging congenital anomaly involving the larynx in children. Management is not uniform, and no single treatment modality has been accepted as ideal. During the last several years only a few articles have dealt with this topic. The purpose of this review is to examine the published literature and discuss the alternative treatments of SGH. The authors also describe their approach and the use of microdebrider as a new surgical tool.
Observation is an option for the rare case of SGH with minimal airway obstruction. However, most cases will require some additional intervention. Systemic steroids intralesional steroid injection, laser ablation with both the CO2 and KTP lasers, interferon (IFN) and open surgical excision have all been utilized.
The authors found few technical innovations in this field in the last 5 years. All techniques utilized have some degree of success. However, all approaches have downsides and are associated with complications, some of which can be very serious. Ideally, more structured research comparing techniques would be helpful to best determine operative and postoperative management.
声门下血管瘤是一种累及儿童喉部的具有挑战性的先天性异常。治疗方法并不统一，尚无单一治疗方式被公认为理想方法。在过去几年中，仅有少数文章涉及该主题。本综述的目的是审视已发表的文献并讨论声门下血管瘤的替代治疗方法。作者还描述了他们的治疗方法以及将微型清创器作为一种新的手术工具的应用。
对于气道阻塞极小的罕见声门下血管瘤病例，观察是一种选择。然而，大多数病例将需要一些额外的干预措施。全身类固醇、瘤内类固醇注射、二氧化碳激光和磷酸钛钾激光消融、干扰素以及开放性手术切除均已被采用。
作者发现在过去5年中该领域几乎没有技术创新。所采用的所有技术都有一定程度的成功。然而，所有方法都有缺点且伴有并发症，其中一些可能非常严重。理想情况下，进行更具结构性的技术比较研究将有助于最佳地确定手术及术后管理。
