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Clinical Outcomes of Infants With Periorbital Hemangiomas Treated With Oral Propranolol.
J Oral Maxillofac Surg. 2016 Nov; 74(11):2193-2199.JO

Abstract

PURPOSE

Periorbital infantile hemangiomas (IHs) require early intervention because they have the potential risk of causing visual disturbances. In recent years, propranolol has shown promise in the effective management of periocular and periorbital IHs. The objective of our study was to assess the clinical outcomes, efficacy, and safety of propranolol in the management of infants with high-risk periorbital IHs.

PATIENTS AND METHODS

This retrospective study was conducted at the Stomatological Hospital affiliated with China Medical University. The medical records of infants with periorbital hemangiomas who were treated with systemic propranolol at a dose of 1.0 to 1.5 mg/kg per day between January 2014 and June 2015 were reviewed. We excluded infants who did not qualify for propranolol treatment and infants who received previous therapy or other treatments. The records were reviewed for treatment response, adverse events during treatment, length of treatment, and recurrences. Treatment response was classified using a 4-point scale system based on reduction in volume as poor (<25%), moderate (25 to 50%), good (50 to 75%), or excellent (>75 to 100%) and change in color, as well as surface texture, by a panel of 3 plastic surgeons using 2-dimensional photographs, clinical examination, and Doppler ultrasonography measurements taken before and after treatment.

RESULTS

Of 38 infants with periorbital hemangiomas, 26 were treated with systemic propranolol at a dose of 1.0 to 1.5 mg/kg administered once daily. A total of 11 male and 15 female infants with a mean age of 5.2 months (range, 2 to 12 months) were treated. The mean length of treatment was 22 weeks (range, 4 to 41 weeks). Adverse events of diarrhea (n = 3) and sleep changes (n = 1) were encountered during treatment in 4 patients. The overall treatment response was scored as excellent in 17 patients, good in 7, moderate in 2, and poor in 0. No patients required discontinuation of treatment because of adverse events, and there were no cases of recurrence or tumor regrowth noted during the mean follow-up period of 6.5 months (range, 3 to 10 months).

CONCLUSIONS

Oral propranolol at a dose of 1.0 to 1.5 mg/kg per day (age ≤3 months, 1.0 mg/kg; age >3 months, 1.5 mg/kg) was effective and well tolerated for the management of 26 Chinese infants with high-risk periorbital IHs. Early intervention should be considered to reduce risk of visual impairment and improve esthetic outcomes.

Authors+Show Affiliations

Attending Surgeon, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.Attending Surgeon, Department of Oral and Maxillofacial Surgery, Yantai Stomatological Hospital, Yantai, China.Resident, Department of Oral and Maxillofacial Surgery, Yantai Stomatological Hospital, Yantai, China.Resident, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China.Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, China. Electronic address: wangxukai757892@sina.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27235180

Citation

Xue, Lei, et al. "Clinical Outcomes of Infants With Periorbital Hemangiomas Treated With Oral Propranolol." Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, vol. 74, no. 11, 2016, pp. 2193-2199.
Xue L, Sun C, Xu DP, et al. Clinical Outcomes of Infants With Periorbital Hemangiomas Treated With Oral Propranolol. J Oral Maxillofac Surg. 2016;74(11):2193-2199.
Xue, L., Sun, C., Xu, D. P., Liu, Z. M., & Wang, X. K. (2016). Clinical Outcomes of Infants With Periorbital Hemangiomas Treated With Oral Propranolol. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, 74(11), 2193-2199. https://doi.org/10.1016/j.joms.2016.04.021
Xue L, et al. Clinical Outcomes of Infants With Periorbital Hemangiomas Treated With Oral Propranolol. J Oral Maxillofac Surg. 2016;74(11):2193-2199. PubMed PMID: 27235180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Outcomes of Infants With Periorbital Hemangiomas Treated With Oral Propranolol. AU - Xue,Lei, AU - Sun,Chao, AU - Xu,Da-Peng, AU - Liu,Zi-Mei, AU - Wang,Xu-Kai, Y1 - 2016/05/02/ PY - 2015/12/28/received PY - 2016/04/18/revised PY - 2016/04/18/accepted PY - 2016/10/30/pubmed PY - 2017/5/4/medline PY - 2016/5/29/entrez SP - 2193 EP - 2199 JF - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons JO - J. Oral Maxillofac. Surg. VL - 74 IS - 11 N2 - PURPOSE: Periorbital infantile hemangiomas (IHs) require early intervention because they have the potential risk of causing visual disturbances. In recent years, propranolol has shown promise in the effective management of periocular and periorbital IHs. The objective of our study was to assess the clinical outcomes, efficacy, and safety of propranolol in the management of infants with high-risk periorbital IHs. PATIENTS AND METHODS: This retrospective study was conducted at the Stomatological Hospital affiliated with China Medical University. The medical records of infants with periorbital hemangiomas who were treated with systemic propranolol at a dose of 1.0 to 1.5 mg/kg per day between January 2014 and June 2015 were reviewed. We excluded infants who did not qualify for propranolol treatment and infants who received previous therapy or other treatments. The records were reviewed for treatment response, adverse events during treatment, length of treatment, and recurrences. Treatment response was classified using a 4-point scale system based on reduction in volume as poor (<25%), moderate (25 to 50%), good (50 to 75%), or excellent (>75 to 100%) and change in color, as well as surface texture, by a panel of 3 plastic surgeons using 2-dimensional photographs, clinical examination, and Doppler ultrasonography measurements taken before and after treatment. RESULTS: Of 38 infants with periorbital hemangiomas, 26 were treated with systemic propranolol at a dose of 1.0 to 1.5 mg/kg administered once daily. A total of 11 male and 15 female infants with a mean age of 5.2 months (range, 2 to 12 months) were treated. The mean length of treatment was 22 weeks (range, 4 to 41 weeks). Adverse events of diarrhea (n = 3) and sleep changes (n = 1) were encountered during treatment in 4 patients. The overall treatment response was scored as excellent in 17 patients, good in 7, moderate in 2, and poor in 0. No patients required discontinuation of treatment because of adverse events, and there were no cases of recurrence or tumor regrowth noted during the mean follow-up period of 6.5 months (range, 3 to 10 months). CONCLUSIONS: Oral propranolol at a dose of 1.0 to 1.5 mg/kg per day (age ≤3 months, 1.0 mg/kg; age >3 months, 1.5 mg/kg) was effective and well tolerated for the management of 26 Chinese infants with high-risk periorbital IHs. Early intervention should be considered to reduce risk of visual impairment and improve esthetic outcomes. SN - 1531-5053 UR - https://www.unboundmedicine.com/medline/citation/27235180/Clinical_Outcomes_of_Infants_With_Periorbital_Hemangiomas_Treated_With_Oral_Propranolol_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0278-2391(16)30121-5 DB - PRIME DP - Unbound Medicine ER -