Comprehensive Management of Infantile Hemangiomas Involving the Periorbital Region

Ann Plast Surg. 2022 Oct 1;89(4):391-394. doi: 10.1097/SAP.0000000000003272. Epub 2022 Aug 18.

Abstract

Periocular infantile hemangioma (pIH) is associated with a risk of vision loss and requires urgent medical intervention. We evaluated the outcomes of the comprehensive management of 44 pIH patients (aged 2-6 months) with superficial (n = 11), deep (n = 15), and mixed (n = 18) subtypes, treated with a standard propranolol dose (2 mg kg -1 d -1 ) without any obvious side effects. Obvious and slight improvements were observed in 70.5% and 29.5% of patients, respectively. Obvious improvement was found in 96.3% of patients 3 months or younger but only 29.4% of patients older than 3 months ( P = 0.036) after 4 weeks of treatment. Thirteen patients demonstrated slight improvement and were treated with an increased propranolol dose (3 mg kg -1 d -1 ) in combination with corticosteroid injections or plastic surgery, which led to good outcomes. The patients were followed up for 12 to 18 months, with no cases of amblyopia or ametropia. Oral propranolol was effective in the treatment of pIH. Earlier propranolol use was associated with better outcomes. An increased propranolol dose combined with corticosteroid injections or plastic surgery is appropriate for patients with propranolol resistance.

MeSH terms

  • Administration, Oral
  • Adrenergic beta-Antagonists / therapeutic use
  • Face
  • Hemangioma, Capillary* / drug therapy
  • Humans
  • Infant
  • Propranolol / therapeutic use
  • Retrospective Studies
  • Skin Neoplasms* / drug therapy
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Propranolol