ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

New Approaches to Vascular Anomalies On the Horizon

by Heather Lindsey • June 1, 2009

  • Tweet
  • Email
Print-Friendly Version

Additionally, physicians should be aware that congenital hemangiomas do not respond to steroids, said Dr. Bauman. Congenital hemangiomas differ from infantile hemangiomas in that they are present at birth and sometimes have a distinctive appearance with a halo of normal appearing skin that slopes upward toward the border of the hemangioma.

You Might Also Like

  • Multidisciplinary Treatment Needed for Vascular Anomalies
  • Propranolol Reduces Size and Blood Vessel Density of Infantile Hemangiomas
  • SM12: Hemangiomas in Infants Require Careful Diagnosis
  • An Unofficial First-Line Treatment: Propranolol gains widespread use for infantile hemangiomas
Explore This Issue
June 2009

Congenital hemangiomas are divided into rapidly involuting lesions (RICH), which resolve during the first year of life, and noninvoluting hemangiomas (NICH), which do not resolve, said Dr. Bauman. The diagnosis is not always clear, but infantile hemangiomas express glucose 1 transporter protein (glut-1 positive), whereas congenital hemagniomas do not, she said.

Corticosteroids remain the standard of care, but researchers are actively investigating a potential new treatment. A recent French study of 11 children summarized in a short communication to the New England Journal of Medicine (2008;358:2649-51) has generated some interest in the use of propranolol for hemangiomas, noted Dr. Siegfried.

Researchers described two children with hemangiomas who received corticosteroids but were given propranolol at 2 mg/kg of body weight per day to address either obstructive hypertrophic cardiomyopathy or increased cardiac output. After receiving propranolol, their hemangiomas improved. Investigators gave propranolol to nine more children with hemangiomas, and all experienced a change in tumor color, from red to purple, and a softening of the lesion within 24 hours.

Joseph E. Kerschner, MDWe’ve done dozens and dozens of procedures with OK-432 and never had a complication due to its use.
-Joseph E. Kerschner, MD

Vasoconstriction, decreased expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (BFGF), and apoptosis of capillary endothelial cells may explain the therapeutic effect of propranolol, wrote the study authors.

The French study looks promising, but we don’t have enough data to make propanolol a first-line drug, said Dr. Siegfried, who along with several colleagues, wrote a response to the study (NEJM 2008; 359:2846-7). The authors of the paper didn’t have space to talk about how to use the drug, she said, adding that the dosing described could cause bradycardia, hypotension, or sustained hypoglycemia, the last of which has been associated with seizures or cerebral palsy in infants.

In their letter, Dr. Siegfried and her colleagues described a propanolol protocol that includes a baseline echocardiogram and either 48-hour hospitalization or home nursing visits to monitor vital signs and blood glucose levels. Propranolol is given every eight hours, with a starting dose of 0.16 mg/kg. The dose is incrementally doubled to a maximum of 0.67 mg/kg/dose or 2.0 mg/kg daily, if the patient has normal vital signs and glucose levels. The drug is then be tapered over a two-week period.

Pages: 1 2 3 4 5 6 7 | Single Page

Filed Under: Everyday Ethics, Head and Neck, Pediatric Tagged With: infantile hemangiomas, lymphatic malformations (LM), pediatric, tumorIssue: June 2009

You Might Also Like:

  • Multidisciplinary Treatment Needed for Vascular Anomalies
  • Propranolol Reduces Size and Blood Vessel Density of Infantile Hemangiomas
  • SM12: Hemangiomas in Infants Require Careful Diagnosis
  • An Unofficial First-Line Treatment: Propranolol gains widespread use for infantile hemangiomas

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Non-Acidic Reflux Explains Lack of Response to H2 Blockers and PPIs
    • Vertigo in the Elderly: What Does It Mean?
    • Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Why Virtual Grand Rounds May Be Here to Stay
    • Otolaryngologist Leverages His Love of Pinball into Second Business
    • These New Imaging Advances May Help to Protect Parathyroids
    • Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say
    • Which Otologic Procedures Poses the Greatest Risk of Aerosol Generation?

Polls

Have you used 3D-printed materials in your otolaryngology practice?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.