Mahadevan Murali, Cheng Alan, Barber Colin
Department of Otolaryngology, Head and Neck Surgery, Starship Children’s Hospital, Auckland, New Zealand.
ANZ J Surg. 2011 Jun;81(6):456-61. doi: 10.1111/j.1445-2197.2010.05643.x.
Subglottic hemangiomas (SGH) are a rare tumour, often associated with significant airway obstruction in infants. Current treatment options, while effective, often expose the infant to potential complications. Emerging evidence suggests a role for the beta blocker propranolol in the initial management of SGH.
We report our experience with propranolol 2 mg/kg/day in 10 consecutive cases of SGH with significant airway obstruction (age range 2–4 months).
After a mean of 7.7 months of treatment, symptom resolution was observed in all cases and eight infants had regression and were stable. Two patients experienced regrowth after 9 months of therapy. To date, no infant has had a tracheostomy or surgical removal of the lesion.
Early results with propranolol are promising; it is effective in controlling SGH, has a rapid onset of action, appears to obviate the need for tracheostomy and can allow tapering of the corticosteroid dose. Repeat laryngoscopy will be required to map the clinical course of these children and elucidate the long-term benefits of propranolol.
声门下血管瘤（SGH）是一种罕见肿瘤，常与婴儿严重气道阻塞相关。目前的治疗方法虽有效，但常使婴儿面临潜在并发症。新出现的证据表明β受体阻滞剂普萘洛尔在SGH的初始治疗中发挥作用。
我们报告了连续10例伴有严重气道阻塞的SGH（年龄范围2 - 4个月）使用普萘洛尔2 mg/kg/天的经验。
平均治疗7.7个月后，所有病例症状均得到缓解，8例婴儿血管瘤消退且病情稳定。2例患者在治疗9个月后血管瘤复发。迄今为止，尚无婴儿接受气管切开术或病变手术切除。
普萘洛尔的早期治疗结果令人鼓舞；它能有效控制SGH，起效迅速，似乎可避免气管切开术的需要，并可减少皮质类固醇剂量。需要重复喉镜检查以明确这些儿童的临床病程并阐明普萘洛尔的长期益处。
