الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Subglottic hemangiomas are rare tumors, but they also are the most commonly seen pediatric airway tumors and they represent 1.5% of congenital laryngeal anomalies. They are more common in females than in males. They are associated with Caucasian ethnicity, low birth weight, prematurity and multiple gestations.
Our study was a retrospective study which was conducted on 97 infants who were diagnosed as subglottic hemangioma seen at Respiratory Paediatric Department of Alexandria University Children hospital and Otorhinolaryngology Department of Alexandria Main University Hospital, Faculty of Medicine from January 2002 to December 2012.
Medical records of each patient will be reviewed for details of clinical presentation, management, and outcome.
Statistical analysis of data obtained from the present study revealed the following results:
The average number of cases increased from 3.3 cases in the first three years of diagnosis to 16.3 cases in the last 3 years of diagnosis. It was noted that 50.5 % of cases was diagnosed from 2010 to 2012 while 39.2% was diagnosed from 2002 to 2008 and 10.3 % of cases was diagnosed in 2009. Females were more common and they represented 78.4 % of cases while males represented 21.6% of cases. The average age of onset was 2.8 ±1.1 months while the average age of diagnosis was 5.6± 1.7 months. Biphasic stridor was the most common presenting symptom and it was found in 87.6% of the cases. Sixty-eight percent (68%) of the cases had grade 3 airway obstruction and 35.1% of the cases associated with cutaneous hemangiomas.
Patients in our study were divided in to three groups: group (1) which represented 30.9% of cases of SGHs and they received oral steroids, group (2) which represented 52.6% of cases of SGHs and they received oral propranolol and group (3) which represented 16.5% of cases of SGHs and they received both oral steroids and oral propranolol.
Group (1) which included 30 cases who were treated with steroids from year 2002 to 2008 in dose 2mg/kg/day orally on 3 divided doses daily from six to twelve months and then the dose was tapered according to the patient’s response. Group (2) which included 51 cases who were treated with propranolol (8 cases of them in 2009 who were received propranolol of dose 1mg/kg/dose three times daily and 43 cases of them from 2010 to 2012 who were received propranolol of dose 1mg/kg/dose three times daily). The duration of treatment ranged from eight to eighteen months which varied from patient to patient. Group (3) This group included 16 patients who received both oral steroids with dose 2mg/kg/day on three divided doses and oral propranolol with dose 1mg/kg/dose three times daily and they represented 16.5% of cases. Eight of them represented 50% of cases in 2008, two of them representing 12.5% of cases in 2009, and six of them representing 37.5% of cases from 2010 to 2012.
Group (1) which included 30 cases who were treated with steroids, 40 % of cases showed rapid response while 36.7 % of cases showed slow response and 23.3% of cases showed no response to treatment. Group (2) which included 51 cases who were treated with propranolol, 88.2% of cases showed very rapid response while 9.8 % of cases showed rapid response and only 2% of cases not responded to treatment.Group (3) which included 16 cases treated with propranolol and steroids, 31.3% of cases showed rapid response while 56.3 % of cases showed slow response and 12.4% of cases showed no response to treatment.