Subglottic Hemangioma: A New Approach to Management

Tracheostomy, followed by irradiation or, more recently, systemic corticosteroids, has been the treatment of choice for airway obstruction caused by subglottic hemangioma.^1-3 Temporary nasotracheal intubation for other causes of severe upper airway obstruction, such as epiglottitis and infectious croup has largely supplanted tracheostomy. The purpose of this report is to present a case of subglottic hemangioma producing severe airway obstruction that was successfully treated by the use of short-term nasotracheal intubation and systemic corticosteroids.

Report of a Case.—A 3-month-old girl was referred for admission for evaluation of inspiratory stridor of approximately six weeks' duration. The child was noted to be in moderate respiratory distress, with inspiratory stridor and intercostal and subcostal retractions. A 5 × 8-mm "strawberry" hemangioma that had enlarged progressively from birth was noted on the right side of the neck. The rest of the examination was normal. An arterial blood sample on admission showed Po