Ezeh UC, Ben-Dov T, Taufique ZM, Gaffey MM, Blei F, April MM. A New Approach for Diagnosis and Surveillance of Infantile Subglottic Hemangioma in the Era of Propranolol Use: A Case Series.
Ann Otol Rhinol Laryngol 2024;
133:145-151. [PMID:
37551026 DOI:
10.1177/00034894231191831]
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Abstract
OBJECTIVE
To report our institutional experience in diagnosing and surveilling patients with infantile subglottic hemangioma (SGH) using in-office flexible fiberoptic laryngoscopy (FFL) with video technology, without requiring operative endoscopy in the era of propranolol use.
METHODS
A retrospective case series was conducted on 4 children diagnosed with SGH between 2016 and 2022 at our institution.
RESULTS
Awake FFL with video technology provided adequate visualization of SGH lesions for diagnosis, without any complications. Serial examinations of the airway were performed in the outpatient setting and each SGH gradually regressed, with marked improvement in respiratory symptoms within 48 hours of oral propranolol initiation.
CONCLUSION
Our findings showed that in select patients, FFL with video technology can successfully identify SGH lesions without general anesthesia exposure. FFL may be used as a low-risk screening tool for propranolol therapy initiation in some patients, but operative endoscopy should remain the gold standard procedure for others. By utilizing FFL in this manner, it is possible to diagnose SGH lesions and start propranolol therapy without exposing all patients to the risks of operative endoscopy.
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