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Efficacy and rebound rates in propranolol‐treated subglottic hemangioma: A literature review
Author(s) -
Schwartz Tyler,
Faria John,
Pawar Sachin,
Siegel Dawn,
Chun Robert H.
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26818
Subject(s) - propranolol , medicine , infantile hemangioma , hemangioma , airway , surgery , anesthesia
Objective Propranolol has recently become the treatment of choice for management of subglottic and airway hemangiomas. This literature review aimed to determine the success rate of propranolol for managing these lesions as well as the rate of rebound growth following propranolol treatment cessation. Study Design Literature search involving MEDLINE and Scopus to identify English‐language articles. Methods Studies were identified using hemangioma, subglottic or airway, and propranolol for search terms. Studies were eligible for inclusion if they reported the treatment used, individual deidentified patient data, and contained patients without medical or surgical treatment prior to propranolol therapy Results Initial review included 107 abstracts. Twenty‐four articles including case reports and case series met inclusion criteria and were included in the qualitative analysis. Forty‐nine patients were included. Twenty‐eight (57%) were treated with propranolol alone, and 20 (41%) were treated with a combination of propranolol and a corticosteroid. Thirty‐seven (76%) of patients were treated with a dose of 2 mg/kg/d of propranolol. The initial treatment was successful in 43 (88%) of patients. Rebound growth occurred in four (9%) patients. Overall, six (12%) patients underwent surgical resection. Conclusions Propranolol is efficacious for treating subglottic hemangiomas. Rebound growth does occur in a small subset of patients during the propranolol wean. Close observation for children during weaning of propranolol therapy for subglottic hemangioma is essential. Adjunctive management strategies need to be used in patients with rebound growth. Laryngoscope , 127:2665–2672, 2017