Management of congenital subglottic hemangioma: trends and success over the past 17 years

OBJECTIVE: To evaluate the success and complications of various treatment options of congenital subglottic hemangioma.

STUDY DESIGN AND SETTINGS: Reported cases were grouped by treatment modalities and corresponding outcome evaluated.

RESULTS: From 1986 through 2002, 372 patients were reported in 28 series. Carbon dioxide laser had 88.9% success rate yet 5.5 % significant subglottic stenosis. It shortened the tracheotomy duration by 13.7 months. Corticosteroids were not that beneficial (useful in only 24.5%) with 12.9% side effects. Intralesional corticosteroids were successful in 86.4% with 5.6% complication rate. Surgical excision (as young as 2.5 months), was useful in 98% with 10% complication rate, using cartilage grafts in 34%. Other modalities were less popular.

CONCLUSION: Treatment should be individualized. Guidelines are suggested. Priority is given to secure the airways. The CO 2 laser is useful when used cautiously. Steroids may be beneficial. Excision is for stubborn cases.