2024/12/31 by F Khalsi., H Louati, I Belhadj +6
#Haemangioma #Hémangiome #Infant #Larynx #Nourrisson #Propanolol #Propranolol #Sous-glottique #Subglottic
paper · doi:10.71566/pist-rmp-194891
Infantile haemangioma(IH) isthe most commontumourduring earlychildhood. Althoughthese benign lesions resolve spontaneously, up until recently laryngotracheal sites of IH required invasive management. The dramatic efficacyofbeta-blockers on IH has radicallychanged the prognosis. Surgeryis nowno longer indicatedasfirst-linetherapy,butshouldonlybeperformedfordifficult,refractorycases,orinthepresence ofabsolutecontraindicationstobeta-blockers. Propranololcanbeusedasfirst-line,single-agenttherapy. Casereport:A2 -month- old girl presentedwith upperairway obstruction. Thisdyspneawasrelatedtoasubglot- tichemangiomadiagnosedattheageof4months. Havingstartedsystemicsteroids,concurrentpro- pranolol therapywas commenced. Propranolol was givenwithclosemonitoringofthebloodpressure, pulseandcapillaryglucoselevel. Thedoseofpro- pranololwasgraduallyincreasedto3mg/kgtotal dailydose,with simultaneous reduction andwit- hdrawalofsteroids. Treatmentwithoralpropranolol resulted in resolution of symptoms and areduction in lesion size. Conclusion:Propranolol has transformed the prognosis and management oflaryngotracheal IH. Surgeryno lon- ger appears to be justified as first-line treatment, butshouldbereservedfordifficult,refractorycases, or in the case of absolute contraindications to all beta-blockers. Althoughpracticeguidelinesarestill incomplete, the use of beta-blockers has conside- rablysimplifiedthetherapeutic management ofla- ryngotracheal IH.