Seikaly H, Cuyler J P
Department of Otolaryngology, MacKenzie Health Science Centre, Edmonton, Alberta.
J Otolaryngol. 1994 Apr;23(2):135-7.
Infantile subglottic hemangiomas are rare congenital lesions of the larynx that are difficult to manage. Our experience with 10 cases was reviewed. All patients presented with stridor at birth, or shortly after. The minimum follow-up was 6 months, with an average of 44 months. The patients were classified and treated according to the size of the hemangioma. The treatment included expectant management, systemic steroids, CO2 laser excision, and tracheostomies. Overall, eight patients were cured, one developed subglottic stenosis, and one died due to unrelated causes. We recommend that (1) patients with small lesions (< 25% of lumen) be treated expectantly, (2) patients with moderate lesions (25-60% of lumen) be treated with systemic steroids initially, and CO2 laser excision if steroids fail, and (3) patients with large lesions (> 60% of lumen) be treated with tracheostomies initially, and staged CO2 laser excision.
小儿声门下血管瘤是罕见的喉部先天性病变，难以处理。我们回顾了10例患者的经验。所有患者在出生时或出生后不久即出现喘鸣。最短随访时间为6个月，平均为44个月。根据血管瘤的大小对患者进行分类并治疗。治疗方法包括观察等待、全身使用类固醇、二氧化碳激光切除和气管切开术。总体而言，8例患者治愈，1例发生声门下狭窄，1例因无关原因死亡。我们建议：（1）小病变（<管腔25%）的患者进行观察等待治疗；（2）中度病变（管腔25%-60%）的患者最初采用全身类固醇治疗，若类固醇治疗无效则行二氧化碳激光切除；（3）大病变（>管腔60%）的患者最初行气管切开术，并分期进行二氧化碳激光切除。
