Management of hemangiomas of the head and neck in children.

Hemangiomas occur in approximately 1% of Caucasian children, and the head and neck is a common site of presentation. Lesions in this region may cause morbidity and occasionally mortality by virtue of complications such as ulceration, infection, hemorrhage, hemodynamic change, aerodigestive tract obstruction and disfigurement. The majority of hemangiomas regress spontaneously. Those with impending complications may require treatment with several modalities. Embolization, surgery, laser therapy, cryotherapy and medical therapy with steroids and antifibrinolytic agents may be used in selected situations. Radiotherapy is now rarely favored due to potential induction of late malignancies. The natural history of these lesions is discussed along with the treatment modalities available and indications for use. Several representative cases are presented.