Emerging concepts in airway infantile hemangioma assessment and management

Objective: The purpose of this study was to evaluate changes in airway infantile hemangioma treatment. Study Design: Retrospective. Subjects: Airway hemangioma patients, tertiary pediatric hospital. Methods: Data collected included age at diagnosis, evaluation methods, hospitalizations, airway size, and interventions. Patients were divided into group A (1981-1993) and group B (1994-2005) and were analyzed using descriptive statistics, the Fisher exact test, and the Student t test. Results: Thirty-two subjects were identified. Nasopharyngoscopy was used more in group B (11/16 [69%]) than group A (4/16 [25%], P = 0.032). CT angiography (3/16 [19%]) and laryngeal distractors (11/16 [69%]) were only used in group B; these techniques showed airway hemangiomas to be "transglottic," not just "subglottic." Intralesional steroids alone (3/16 [19%]) and primary hemangioma excision (2/16 [13%]) were new treatments used in group B. Frequent direct laryngoscopies (>six) correlated with tracheotomy (5/32 [16%], P = 0.015). Presenting age (<2 months) impacted treatment more than airway hemangioma size. Conclusions: New methods of airway infantile hemangioma assessment changed our concept of airway hemangiomas and their primary treatment.