Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University Varanasi 221005, India.
Department of Pediatric surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
J Stomatol Oral Maxillofac Surg. 2022 Oct;123(5):e499-e505. doi: 10.1016/j.jormas.2022.02.010. Epub 2022 Feb 22.
Propranolol has evolved as a first line management of infantile haemangiomas. Nevertheless, the resistance to propranolol has warranted alternative treatment modalities. We hypothesize that combination of medical and surgical therapy (sandwich therapy) to be beneficial in the management.
Patients were divided into three groups (total=31), Group A (bleomycin sclerotherapy), Group B (surgical group), Group C (sandwich therapy). A p value <0.05 was taken as significant.
In Group A 54.5% of patients had excellent response, 27.3% partial response and 18.2% had no response. Comparing cosmetic outcome, 25% of patients in Group B and 16.7% of patients in Group C had excellent upshot. On the contrary 18.2% of patients in bleomycin had unsatisfactory and 18.2% had poor cosmetic outcome. Sandwich therapy was cosmetically more acceptable than Bleomycin sclerotherapy (p- value = 0.049). In terms of recurrence, sandwich therapy differed significantly from surgical therapy with fewer recurrences (p-value= 0.049).
Sandwich therapy is superior to bleomycin sclerotherapy in terms of cosmetic outcome and has fewer recurrences compared to surgical group and requires single stage resection. However, further studies with the help of Doppler ultrasound are required in this regard.
普萘洛尔已发展成为婴儿血管瘤的一线治疗方法。然而，普萘洛尔的耐药性需要替代治疗方法。我们假设将医学和手术治疗相结合（三明治疗法）对治疗有益。
患者分为三组（共 31 例），A 组（博来霉素硬化治疗）、B 组（手术组）、C 组（三明治治疗）。p 值<0.05 为显著。
A 组 54.5%的患者有极好的反应，27.3%的患者有部分反应，18.2%的患者没有反应。比较美容效果，B 组 25%的患者和 C 组 16.7%的患者有极好的结果。相反，博来霉素组 18.2%的患者不满意，18.2%的患者美容效果差。三明治疗法在美容方面比博来霉素硬化疗法更可接受（p 值=0.049）。在复发方面，三明治疗法与手术治疗的复发率有显著差异（p 值=0.049）。
在美容效果方面，三明治疗法优于博来霉素硬化疗法，与手术组相比复发率较低，且只需单阶段切除。然而，在这方面需要借助多普勒超声进行进一步的研究。
