MANAGEMENT OF SUBGLOTTIC HEMANGIOMA

Two contrasting methods of treatment for paediatric subglottic haemang ioma are presented, Dr Hoeve describes his results using intralesional steroids and short-term intubation, and Dr Froehlich discusses his ou tcomes with open surgical excision. Mr Bailey then reviews the current ly available therapeutic options with special reference to each of the above techniques, and suggests an optimum plan of management given ou r current state of knowledge. The conclusion is that very small haeman giomas may not require treatment, or may be amenable to CO2 laser vapo rization. Medium-sized lesions seem suitable for intra-lesional steroi ds and intubation, but large ones are probably best managed by primary submucous resection. Very large haemangiomas, and especially those wh ich are circumferential or in which magnetic resonance imaging (MRI) s hows extension down into the trachea and/or through the tracheal wall into the surrounding tissues, may be more safely dealt with by perform ing a tracheostomy and awaiting spontaneous involution.