Subglottic hemangioma

Subglottic haemangiomas (SGH) are rare vascular malformations that enlarge from shortly after birth around the third month and grow until 10–18 months of age, after which spontaneous involution begins. Complete regression occurs by 5–8 years of age.

They can be present on the skin (scalp, face, chest or the back). They are benign on the skin surface, though if they are present within the larynx and trachea, they can cause significant breathing difficulties and stridor. Clearly, size of the hemangioma would decide the degree of respiratory distress.

The diagnosis of a subglottic hemangioma is done during an endoscopy.

The principles of treatment of SGH are to maintain a patent airway. A selective beta blocker is now the standard in the treatment of subglottic hemangioma. Before starting it, the child has to undergo complete blood counts plus glucose levels, cardiology examination and an MRI to rule out mediastinal hemangiomas. The beta blocker is given for 6-12 months. CO2 laser is used in selected cases to reduce the size of the hemangioma and thus treat the airway compromise.