Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Feb 8, 2016; 5(1): 95-101
Published online Feb 8, 2016. doi: 10.5409/wjcp.v5.i1.95
Analysis of the therapeutic evolution in the management of airway infantile hemangioma
Grecia V Vivas-Colmenares, Israel Fernandez-Pineda, Juan Carlos Lopez-Gutierrez, Miguel Angel Fernandez-Hurtado, Maria Antonia Garcia-Casillas, Jose Antonio Matute de Cardenas
Grecia V Vivas-Colmenares, Israel Fernandez-Pineda, Miguel Angel Fernandez-Hurtado, Jose Antonio Matute de Cardenas, Department of Pediatric Surgery, Virgen del Rocio Children’s Hospital, 41013 Sevilla, Spain
Juan Carlos Lopez-Gutierrez, Department of Pediatric Surgery, La Paz’s Children’s Hospital, 28046 Madrid, Spain
Maria Antonia Garcia-Casillas, Department of Pediatric Surgery, Gregorio Marañon Children’s Hospital, 28009 Madrid, Spain
Author contributions: Vivas-Colmenares GV, Fernandez-Pineda I, Lopez-Gutierrez JC, Fernandez-Hurtado MA, Garcia-Casillas MA and Matute de Cardenas JA designed the editorial article and wrote the manuscript; all authors had read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Virgen del Rocio Children’s Hospital, La Paz’s Children’s Hospital and Gregorio Marañon Children’s Hospital Institutional.
Informed consent statement: All study participants, or their legal guardian provided informed verbal consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at josea.matute.sspa@juntadeandalucia.es. Participants gave verbal consent.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jose Antonio Matute de Cardenas, MD, Department of Pediatric Surgery, Virgen del Rocio Children’s Hospital, Av. Manuel Siurot s/n, 41013 Sevilla, Spain. josea.matute.sspa@juntadeandalucia.es
Telephone: +34-95-5012924 Fax: +34-95-5012936
Received: July 23, 2015
Peer-review started: July 27, 2015
First decision: August 26, 2015
Revised: September 25, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: February 8, 2016
Processing time: 188 Days and 2.9 Hours
Abstract

AIM: To analyze the evolution in the management of airway infantile hemangioma (AIH) and to report the results from 3 pediatric tertiary care institutions.

METHODS: A retrospective study of patients with diagnosis of AIH and treated in 3 pediatric tertiary care institutions from 1996 to 2014 was performed.

RESULTS: Twenty-three patients with diagnosis of AIH were identified. Mean age at diagnosis was 6 mo (range, 1-27). Single therapy was indicated in 16 patients and 7 patients received combined therapy. Two therapeutic groups were identified: Group A included 14 patients who were treated with steroids, interferon, laser therapy and/or surgery; group B included 9 patients treated with oral propranolol. In group A, oral corticosteroids were used in 9 patients with a good response in 3 cases (no requiring other therapeutic option), the other patients required additional treatment options. Cushing syndrome was observed in 3 patients. One patient died of a fulminant sepsis. Open surgical excision and endoscopic therapy were performed in 11 patients (in 5 of them as a single treatment) with a response rate of 54.5%. Stridor persisted in 2 cases, and one patient died during the clinical course of bronchial aspiration. In group B, oral propranolol was used in 9 patients (in 8 of them as a single treatment) with a response rate of 100%, with an mean treatment duration of 7 mo (range, 5-10); complications were not observed.

CONCLUSION: Our experience and the medical literature support the use of propranolol as a first line of treatment in AIH.

Keywords: Infantile hemangioma; Propranolol; Surgery; Airway; Fibrobronchoscopy

Core tip: Through this study we want to highlight the importance of early use of propranolol in the treatment of airway infantile hemangioma. We also want to show our experience with other treatment options including corticosteroids, interferon and surgical and endoscopic treatments used before the propranolol era.