Objective: To discuss the diagnosis and treatment of infantile congenital subglottic hemangioma.
Method: Nine patients with recurrent stridor, feeding difficulties and laryngeal obstruction were diagnosed as congenital subglottic hemangioma with bronchial endoscopy. The lesions were unilateral in 7 cases and bilateral in 2 cases. Eight cases were treated by intralesional Pingyangmycin injection after tracheotomy. Patients were discharged with metal trachea and were followed up endoscopically 2 weeks thereafter. A second treatment would be required if the tumor reduced in size but not disappeared completely. Plugging tubes and extubation would be done when the tumor disappeared completely. One case with unilateral lesion underwent power-assisted tumor resection without tracheotomy.
Result: Hemangioma vanished completely in 6 patients with unilateral subglottic hemangioma who were treated with single stage procedure. Tumor size was found reduced significantly after one procedure and vanished completely after a second procedure in 2 cases with bilateral subglottic hemangioma. All of the 8 cases were extubated successfully. The patient recovered thoroughly in two weeks after power-assisted tumor resection.
Conclusion: Intralesional Pingyangmycin injection after tracheotomy can relief the airway obstruction quickly, shorten the nature course of hemangioma, shorten the period of wearing trachea, has no complication such as subglottic stenosis and is thought to be a safe and effective therapy for large size hemangioma. Power-assisted tumor resection under good total anesthesia without tracheotomy combined with well hemostasis is effective, less injure, and suitable for small size hemangioma.