Modern Management of Nasal Hemangiomas
Autor: | Marcelo Hochman, Robert G. Keller, Shawn M. Stevens |
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Rok vydání: | 2017 |
Předmět: |
Adult
medicine.medical_specialty Adolescent Adrenal cortex hormones medicine.medical_treatment Nose Neoplasms Lasers Dye Injections Intralesional Nose neoplasm Rhinoplasty Hemangioma Young Adult 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Laser therapy Adrenal Cortex Hormones Early Medical Intervention medicine Humans Combined Modality Therapy Child 030223 otorhinolaryngology Nose business.industry Infant Newborn Pulsed dye laser device Infant medicine.disease Propranolol eye diseases Surgery Outcome and Process Assessment Health Care medicine.anatomical_structure Child Preschool sense organs business Algorithms |
Zdroj: | JAMA Facial Plastic Surgery. 19:327-332 |
ISSN: | 2168-6092 2168-6076 |
Popis: | Current treatment approaches for infantile hemangiomas of the nose include observation, pharmacologic agents, surgery, and/or laser therapy. Because of the known functional, social, and cosmetic effect of nasal deformities, obtaining the best possible result is critical. Optimal timing, type, duration, and extent of therapy remain unclear.Results of a review of 86 patients (64 females and 22 males; mean age, 4.8 months [range, 2 days-23 years]) with infantile hemangiomas of the nose treated from January 1, 1999, to December 31, 2015, and a review of the literature are presented to gain insight into the preferred approach to the treatment of these lesions. Patients underwent single-modality and multimodality treatment with pulsed-dye laser (n = 73), oral corticosteroids (n = 11), intralesional corticosteroids (n = 2), propranolol hydrochloride (n = 30), and surgery (n = 50). The treatment decision algorithms and outcomes based on tumor phase and infantile hemangioma subtype are reviewed in detail. Nine articles met the criteria to be included in the literature review. Literature from the era before the approval of propranolol advocates for early use of oral or intralesional corticosteroids followed by surgery or pulsed-dye laser in cases of unacceptable outcomes. Literature from the era after the approval of propranolol supports early initiation of oral β-blockers until proliferation ceases or until additional intervention is necessary.Despite a lack of higher levels of evidence, there exists a general consensus between the literature and clinical experience advocating for early multimodality treatment to achieve the best result possible by the time the children reach certain sociodevelopmental milestones. |
Databáze: | OpenAIRE |
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