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Otolaryngology, ENT & Sinus News Provided by the California Sinus CentersPropranolol in the Management of Airway Infantile Hemangiomas [Original Article]July 1, 2010, 12:00 pm by Archives of Otolaryngology Head & Neck SurgeryObjective To report our experience with propranolol in managing airway infantile hemangiomas. Design Case series of 3 consecutive patients who had extensive, symptomatic airway infantile hemangiomas treated with propranolol. Setting Tertiary academic medical center. Patients Three infants with facial cutaneous hemangiomas who developed stridor that progressed to respiratory distress, which according to laryngoscopic examination results was confirmed to be caused by extensive subglottic hemangiomas. These patients underwent follow-up during their course of therapy, ranging from 3 weeks to 15 months. Results Patient 1 failed to respond to systemic corticosteroids, laser ablation, and intravenous vincristine for her airway hemangioma and had to undergo tracheotomy. She was given propranolol after her tracheotomy and had a significant reduction in her subglottic airway obstruction. Patient 2 developed progressive stridor secondary to airway hemangioma at age 61/2 months following tapering of systemic corticosteroids prescribed for her periorbital hemangioma. Systemic corticosteroids were restarted with the addition of propranolol. The stridor improved within 24 hours, and she was able to be weaned off corticosteroids. Patient 3 was also treated with initial combined therapy of systemic corticosteroids and propranolol. He had a significant reduction in stridor within 24 hours and was weaned off corticosteroids. Conclusions Our 3 patients had severe respiratory symptoms related to their airway infantile hemangiomas. In the first patient, propranolol was used when other treatments were ineffective or associated with intolerable adverse effects. In the second and third patients, propranolol was part of a dual regimen that resulted in rapid resolution of airway symptoms and allowed for quicker weaning of corticosteroids.
More from Archives of Otolaryngology Head & Neck Surgery Professional Burnout Among Microvascular and Reconstructive Free-Flap Head and Neck Surgeons in the United States [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 16, 2010, 12:00 pm Objectives To determine the prevalence of professional burnout among microvascular free-flap (MVFF) head and neck surgeons and to identify modifiable risk factors with the intent to reduce MVFF surgeon burnout.Design A cross-sectional, Iguazu Falls [About the Cover] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm About This Journal [About This Journal] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm The Learning Curve of Sialendoscopy With Modular Sialendoscopes: A Single Surgeon's Experience [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm Objective To assess the learning curve of sialendoscopy with modular endoscopes based on operative parameters and a postoperative performance rating. Design Prospective study, case series. Setting Tertiary referral hospital. Patients The study included 50 consecutive Dexamethasone Administration and Postoperative Bleeding Risk in Children Undergoing Tonsillectomy [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm Objective To assess whether administration of dexamethasone during tonsillectomy is associated with a dose-dependent increased rate of postoperative tonsillectomy hemorrhage. Design Retrospective review of 2788 children and adolescents who underwent tonsillectomy with or
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