Use of propranolol to treat multicentric airway haemangioma

Objective: To report our experience of using propranolol to treat an infantile airway haemangioma. Methods: A five-week-old girl presented with upper airway obstruction. Having started systemic steroids, concurrent propranolol therapy was commenced. Propranolol was given with close monitoring of the blood pressure, pulse and capillary glucose level. The dose of propranolol was gradually increased to 2 mg/kg total daily dose, with simultaneous reduction and withdrawal of steroids. Results: Prior to propranolol treatment, laryngotracheobronchoscopy revealed an extensive haemangioma extending from the posterior pharyngeal wall to the subglottis. Following initiation of propranolol, a dramatic reduction in tumour bulk was seen on repeated laryngotracheobronchoscopy within 10 days of treatment. Eight months on, the patient remained asymptomatic on propranolol, with no endoscopic evidence of disease apart from mild telangiectasia. Conclusion: Haemangiomas of the airway can cause obstruction which may potentially be life-threatening. This case demonstrates the potential of propranolol to become a valuable therapeutic option in such clinical situations.